FORM 1023-EZ for PASSION4PAWS

Field Data
EIN 82-5115757
Case Number EO-2018183-000426
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PASSION4PAWS
Organization’s Mailing Address 9358 E INDIGO MOUNTAIN WAY
City VAIL
State AZ
ZIP 85641-2752
Accounting period End 3
Primary contact name ANDREA MOZOLIK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDREA MOZOLIK
PRESIDENT
9358 E INDIGO MOUNTAIN WAY
VAIL AZ 85641-2752

Officer/Director/Trustee Two

MICHAEL MOZOLIK
OFFICER
9358 EAST INDIGO MOUNTAIN WAY
VAIL AZ 85641-2752

Officer/Director/Trustee Three

FAITH STEPHENSON
OFFICER
564 S BLUE RIVER LOOP
VAIL AZ 85641-2262

Officer/Director/Trustee Four

DEBORAH MEDINA
OFFICER
2632 E REATA RIDGE PLACE
SAHUARITA AZ 85629-6703

Officer/Director/Trustee Five

SILVER MEDINA
OFFICER
2632 E REATA RIDGE PLACE
SAHUARITA AZ 85629-6703

Organization’s website
Organization’s email PASSION4PAWSSOAZ@OUTLOOK.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/4/18
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ANDREA MOZOLIK
Signature Title PRESIDENT
Signature Date 6/30/18

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