FORM 1023-EZ for PAWS ANIMAL RESCUE OF POLK COUNTY

Field Data
EIN 81-2074943
Case Number EO-2016097-000275
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PAWS ANIMAL RESCUE OF POLK COUNTY
Organization’s Mailing Address 2601 OZARK ST
City MENA
State AR
ZIP 71953
Accounting period End 12
Primary contact name MISTY MILLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MISTY MILLER
ORGANIZER/ INCORPORATOR
2601 OZARK ST
MENA AR 71953

Officer/Director/Trustee Two

MISTY MARTIN
VICE PRESIDENT
153 POLK ROAD 41 N
MENA AR 71953

Officer/Director/Trustee Three

KRISTA SMITH
TREASURER
207 POLK ROAD 666
MENA AR 71953

Officer/Director/Trustee Four

ANNIE WHIDHAM
SECRETARY
393 POLK ROAD 31
HATFIELD AR 71953

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/29/2016
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D20 - Animal Protection and Welfare
Organization’s purpose Charitable: No
Religious: No
Educational: No
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 Yes
Gaming Activity Yes
Disaster relief assistance Yes
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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