FORM 1023-EZ for ARIZONA CARDIAC ARREST SURVIVORS INC
| Field | Data |
|---|---|
| EIN | 81-1433648 |
| Case Number | EO-2016074-000259 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | ARIZONA CARDIAC ARREST SURVIVORS INC |
| Organization’s Mailing Address | PO BOX 301 |
| City | PEARCE |
| State | AZ |
| ZIP | 85625 |
| Accounting period End | 12 |
| Primary contact name | GARY W BRAUCHLA |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
Officer/Director/Trustee One
JAMES NEWBERRY
CHAIRMAN OF THE BOARD
6160 N CHRISTMAS TREE LANE
FLAGSTAFF AZ 86004
Officer/Director/Trustee Two
GARY BRAUCHLA
PRESIDENT
PO BOX 301
PEARCE AZ 85625
Officer/Director/Trustee Three
KATHIE REILLY
VICE-PRESIDENT
3060 N 127TH LANE
AVONDALE AZ 85392
Officer/Director/Trustee Four
CAROL GIBBS
SECRETARY
9025 S 47TH PL
PHOENIX AZ 85044
Officer/Director/Trustee Five
KEN GIBBS
TREASURE
9025 S 47TH PL
PHOENIX AZ 85044
| Organization’s website | |
|---|---|
| Organization’s email | AZCASURVIVOR@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 2/10/2016 |
| Organization Incorporation State | AZ |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E70 - Public Health Program (Includes General Health and Wellness Promotion Services) |
| Organization’s purpose | Charitable: Yes Religious: No Educational: No Scientific: No Literary: No Public Safety: No Amateur Sports: No Cruelty Prevention: No |
| 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 | |
| Signature Title | |
| Signature Date |
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