FORM 1023-EZ for EDGEWATER ANIMAL SHELTER INC

Field Data
EIN 83-2642132
Case Number EO-2019037-000370
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EDGEWATER ANIMAL SHELTER INC
Organization’s Mailing Address 605 MANGO TREE DR
City EDGEWATER
State FL
ZIP 32132-2059
Accounting period End 12
Primary contact name ROXANNE HICKS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROXANNE HICKS
SECRETARY
4449 SAXON DR
NEW SMYRNA BEACH FL 32169

Officer/Director/Trustee Two

KAYLA KURTZ
PRESIDENT
1298 WHISPERING PINES CIRCLE
NEW SMYRNA BEACH FL 32168

Officer/Director/Trustee Three

LESLIE HUTCHINSON
VICE PRESIDENT
1400 WILLARD STREET
NEW SMYRNA BEACH FL 32168

Officer/Director/Trustee Four

DENIS ODELL
DIRECTOR
508 MILL RUN DR
NEW SMYRNA BEACH FL 32168

Officer/Director/Trustee Five

ANNA PICKETT
DIR
3116 JUNIPER DR
EDGEWATER FL 32141

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/31/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D20 - Animal Protection and Welfare
Organization’s purpose Charitable: No
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 Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ROXANNE HICKS
Signature Title SECRETARY
Signature Date 12/31/18

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