FORM 1023-EZ for FRIENDS OF PENINSULA REGIONAL ANIMAL SHELTER

Field Data
EIN 84-3042306
Case Number EO-2019340-000156
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FRIENDS OF PENINSULA REGIONAL ANIMAL SHELTER
Organization’s Mailing Address 7288 HANOVER GREEN DRIVE
City MECHANICSVILLE
State VA
ZIP 23111
Accounting period End 12
Primary contact name KELSEY BERGAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELSEY BERGAN
CHAIR
6 SHIRLEY ROAD
NEWPORT NEWS VA 23601

Officer/Director/Trustee Two

CAMILA FERNANDEZ
TREASURER
204 RIVER ROAD
NEWPORT NEWS VA 23601

Officer/Director/Trustee Three

JOHN FODEN
VICE CHAIR
1 BARREL FACTORY COURT
POQUOSON VA 23662

Officer/Director/Trustee Four

DRU JORDAN
SECRETARY
115 SELDEN RD
NEWPORT NEWS VA 23606

Officer/Director/Trustee Five

LINDA CURTIS
DIRECTOR
12 RIDING PATH
HAMPTON VA 23669

Organization’s website
Organization’s email FRIENDSOFPRAS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/10/2019
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D11 - Single Organization Support
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KELSEY BERGAN
Signature Title CHAIR
Signature Date 12/4/2019

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