FORM 1023-EZ for ELLIES POTBELLIES

Field Data
EIN 84-3182494
Case Number EO-2019364-000192
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ELLIES POTBELLIES
Organization’s Mailing Address 2447 CEDARLINE LOOP BOX 569
City STOCKTON
State UT
ZIP 84071
Accounting period End 12
Primary contact name SYLVIA STRONG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEPHANIE SMITH
INCORPORATER
PO BOX 569
STOCKTON UT 84071

Officer/Director/Trustee Two

CYNTHIA WATSON
TRUSTEE
PO BOX 569
STOCKTON UT 84071

Officer/Director/Trustee Three

ROWYN STRONG
TRUSTEE
PO BOX 569
STOCKTON UT 84071

Officer/Director/Trustee Four

SYLVIA STRONG
DIRECTOR
PO BOX 569
STOCKTON UT 84071

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/2019
Organization Incorporation State UT
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: Yes
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 Yes
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SYLVIA STRONG
Signature Title DIRECTOR
Signature Date 12/26/2019

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