FORM 1023-EZ for NORTH AMERICAN VETERINARY ANESTHESIA SOCIETY

Field Data
EIN 82-1628400
Case Number EO-2017160-000193
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NORTH AMERICAN VETERINARY ANESTHESIA SOCIETY
Organization’s Mailing Address 383 CORONA STREET
City DENVER
State CO
ZIP 80218
Accounting period End 12
Primary contact name BRUNO PYPENDOP
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRUNO PYPENDOP
DIRECTOR, PRESIDENT
7435 ELIZABETH ROAD
VACAVILLE CA 95688

Officer/Director/Trustee Two

KHURSHEED MAMA
DIRECTOR, TREASURER
300 W DRAKE
FORT COLLINS CO 80523

Officer/Director/Trustee Three

KRISTEN COOLEY
DIRECTOR, SECRETARY
5941 MONTICELLO WAY
MADISON WI 53719

Officer/Director/Trustee Four

JEANNETTE CREMER
DIRECTOR
9340 BOONE DRIVE
BATON ROUGE LA 70810

Officer/Director/Trustee Five

ASHLEY WIESE
DIRECTOR
3964 RED BANK ROAD
CINCINNATI OH 45227

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/8/2017
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D03 - Professional Societies, Associations
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 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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