FORM 1023-EZ for APACHE COUNTY FRIENDS OF CASA

Field Data
EIN 81-2747876
Case Number EO-2016196-000567
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name APACHE COUNTY FRIENDS OF CASA
Organization’s Mailing Address 470 SOUTH MOUNTAIN AVENUE STE 101
City SPRINGERVILLE
State AZ
ZIP 85938
Accounting period End 12
Primary contact name JACKIELYN HARRINGTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JACKIELYN HARRINGTON
PRESIDENT
470 SOUTH MOUNTAIN AVENUE STE 101
SPRINGERVILLE AZ 85938

Officer/Director/Trustee Two

RICHARD AYRES
SECRETARY
PO BOX 1233
EAGAR AZ 85925

Officer/Director/Trustee Three

DENNIS WEISKIRCHER
DIRECTOR
PO BOX 1700
SPRINGERVILLE AZ 85938

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/11/2016
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P32 - Foster Care
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 Yes
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
Signature Title
Signature Date

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