FORM 1023-EZ for SUNDANCE VETERINARY ALLIANCE INC

Field Data
EIN 82-2777949
Case Number EO-2017258-000423
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SUNDANCE VETERINARY ALLIANCE INC
Organization’s Mailing Address PO BOX 1547
City COTTONWOOD
State AZ
ZIP 86326
Accounting period End 5
Primary contact name DEBRA BOULDIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEBRA BOULDIN
DIRECTOR
699 N 10TH STREET
COTTONWOOD AZ 86326

Officer/Director/Trustee Two

DALE MOTES
DIRECTOR
699 N 10TH STREET
COTTONWOOD AZ 86326

Officer/Director/Trustee Three

KATHRYN BAZAN
DIRECTOR
699 N 10TH STREET
COTTONWOOD AZ 86326

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/6/2016
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D99 - Animal-Related N.E.C.
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 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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