FORM 1023-EZ for SHG OF ARIZONA

Field Data
EIN 86-1285326
Case Number EO-2021147-000354
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHG OF ARIZONA
Organization’s Mailing Address 8 E COTTONWOOD STREET
City COTTONWOOD
State AZ
ZIP 86326-6237
Accounting period End 12
Primary contact name APRIL RHODES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

APRIL RHODES
PRESIDENT AND CEO
8 E COTTONWOOD STREET
COTTONWOOD AZ 86326-6237

Officer/Director/Trustee Two

RANDY TAYLOR
CHAIRMAN
8 E COTTONWOOD STREET
COTTONWOOD AZ 86326-6237

Officer/Director/Trustee Three

RON OLSON
DIRECTOR
8 E COTTONWOOD STREET
COTTONWOOD AZ 86326-6237

Officer/Director/Trustee Four

TOM PENDER
DIRECTOR
8 E COTTONWOOD STREET
COTTONWOOD AZ 86326-6237

Officer/Director/Trustee Five

JANE WITT
VICE PRESIDENT HR
8 E COTTONWOOD STREET
COTTONWOOD AZ 86326-6237

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/24/2020
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F32 - Community Mental Health Center
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: No
Public Safety: Yes
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 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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JANE WITT
Signature Title VICE PRESIDENT HR
Signature Date 5/25/2021

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