FORM 1023-EZ for UNION COUNTY HUMANE SOCIETY

Field Data
EIN 81-1020698
Case Number EO-2016020-000419
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name UNION COUNTY HUMANE SOCIETY
Organization’s Mailing Address 1034 MORGAN DRIVE
City NEW ALBANY
State MS
ZIP 38652
Accounting period End 12
Primary contact name EMILEE BENNETT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

EMILEE BENNETT
PRESIDENT/CHAIR OF BOARD
1018 EVELYN COVE
NEW ALBANY MS 38652

Officer/Director/Trustee Two

ZAK JOHNSON
SECRETARY/TREASURER
1034 MORGAN DR
NEW ALBANY MS 38652

Officer/Director/Trustee Three

ANNA ROBBINS
DIRECTOR
719 HWY 15 N
NEW ALBANY MS 38652

Officer/Director/Trustee Four

PENNIE JERNIGAN
VICE PRESIDENT
1022 COUNTY ROAD 112
NEW ALBANY MS 38652

Officer/Director/Trustee Five

AMY LIVINGSTON
DIRECTOR
605 HIGHLAND STREET
NEW ALBANY MS 38652

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/7/2016
Organization Incorporation State MS
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 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
Signature Title
Signature Date

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