FORM 1023-EZ for A2Z THERAPY OF LITTLE ROCK

Field Data
EIN 84-3045052
Case Number EO-2019288-000418
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name A2Z THERAPY OF LITTLE ROCK
Organization’s Mailing Address 10702 WARREN DRIVE
City LITTLE ROCK
State AR
ZIP 72209
Accounting period End 12
Primary contact name VERNON D THOMAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

VERNON THOMAS
VICE PRESIDENT OF OPERATIONS
10702 WARREN DRIVE
LITTLE ROCK AR 72209

Officer/Director/Trustee Two

JENNIFER BATTLES
MANAGING DIRECTOR
131 VILLAGE CENTER BLVD UNIT 3304
MYRTLE BEACH SC 29579

Officer/Director/Trustee Three

ASHLEY BERRY
EXECUTIVE DIRECTOR OF CLINICAL OPER
3915 TIMBERLAND DRIVE
LITTLE ROCK AR 72204

Organization’s website A2ZTHERAPY.ORG
Organization’s email A2ZTHERAPY@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/13/19
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B28 - Specialized Education Institutions
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
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 Yes
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 JENNIFER BATTLES
Signature Title MANAGING DIRECTOR
Signature Date 10/11/19

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