FORM 1023-EZ for FOUR PAWS MISSISSIPPI

Field Data
EIN 83-3600978
Case Number EO-2019081-000315
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FOUR PAWS MISSISSIPPI
Organization’s Mailing Address 626 ROCKHILL ROAD
City PONTOTOC
State MS
ZIP 38863-9743
Accounting period End 10
Primary contact name SAMANTHA SHEUBROOK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TRAVIS STAPLES
VICE PRESIDENT
626 ROCKHILL ROAD
PONTOTOC MS 38863-9743

Officer/Director/Trustee Two

COLLEEN RILEY
TREASURER
2 DALMENY COURT APT 101
PARKVILLE MD 21234-1647

Officer/Director/Trustee Three

RICHARD SHEUBROOK
SECRETARY
1026 IRIS AVE
BALTIMORE MD 21205-3027

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/15/19
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D01 - Alliance/Advocacy Organizations
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 TRAVIS STAPLES
Signature Title VICE PRESIDENT
Signature Date 3/20/19

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