FORM 1023-EZ for STREET DOGS MOBILE MINISTRY FOR PETHEALTH

Field Data
EIN 81-3447749
Case Number EO-2019310-000278
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name STREET DOGS MOBILE MINISTRY FOR PETHEALTH
Organization’s Mailing Address 2501 N 32ND ST
City PHOENIX
State AZ
ZIP 85008-2140
Accounting period End 12
Primary contact name ANNE ELIZABETH HERSHEY DVM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANNE ELIZABETH HERSHEY DVM
PRESIDENT, DIRECTOR
2501 N 32ND ST
PHOENIX AZ 85008-2140

Officer/Director/Trustee Two

CORRINNE ROUSE
TREASURER, DIRECTOR
2501 N 32ND ST
PHOENIX AZ 85008-2140

Officer/Director/Trustee Three

VANESSA VAN WYK
SECRETARY, DIRECTOR
2501 N 32ND ST
PHOENIX AZ 85008-2140

Officer/Director/Trustee Four

STEPHANIE WIEGAND
DIRECTOR
2501 N 32ND ST
PHOENIX AZ 85008-2140

Officer/Director/Trustee Five

JOANN BURGESS
DIRECTOR
2501 N 32ND ST
PHOENIX AZ 85008-2140

Organization’s website STREETDOGSAZ.COM
Organization’s email INFOR@STREETDOGSAZ.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/23/16
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D40 - Veterinary Services
Organization’s purpose Charitable: Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ANNE ELIZABETH HERSHEY DVM
Signature Title PRESIDENT, DIRECTOR
Signature Date 11/4/19

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