FORM 1023-EZ for SIMPLY SPAY AND NEUTER OF ROCKWOOD TN

Field Data
EIN 81-4382443
Case Number EO-2016348-000296
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SIMPLY SPAY AND NEUTER OF ROCKWOOD TN
Organization’s Mailing Address 768 EAGLE FURNACE RD
City ROCKWOOD
State TN
ZIP 37854
Accounting period End 6
Primary contact name JANICE OSBORNE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JANICE OSBORNE
DIRECTOR
768 EAGLE FURNACE RD
ROCKWOOD TN 37854

Officer/Director/Trustee Two

ANNETTE DOERING
DIRECTOR
216 CIRCLE DR
ROCKWOOD TN 37854

Officer/Director/Trustee Three

CAROLYN WHITEHEAD PARK
DIRECTOR
208 SOUTH CHAMBERLAIN AVE
ROCKWOOD TN 37384

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/5/2016
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D60 - Other Services - Specialty Animals
Organization’s purpose Charitable: No
Religious: No
Educational: No
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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