FORM 1023-EZ for HUMBOLDT DEL NORTE VETERINARY MEDICAL ASSOCIATION

Field Data
EIN 68-0066084
Case Number EO-2017138-000254
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HUMBOLDT DEL NORTE VETERINARY MEDICAL ASSOCIATION
Organization’s Mailing Address 2715 HUBBARD LANE
City EUREKA
State CA
ZIP 95501-4842
Accounting period End 12
Primary contact name TAMI REYNOLDS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JENNIFER TAVARES
PRESIDENT
3700 BROADWAY
EUREKA CA 95503-5705

Officer/Director/Trustee Two

TAMI REYNOLDS
SECRETARY
900 BUTTERMILK LANE
ARCATA CA 65521-6799

Officer/Director/Trustee Three

CRYSTAL MCCONNELL
TREASURER
2715 HUBBARD LANE
EUREKA CA 95501-4842

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/6/1961
Organization Incorporation State CA
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: No
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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