FORM 1023-EZ for ANGELS OF MERCY FOR JD PAIZ INC

Field Data
EIN 47-4520003
Case Number EO-2015310-000424
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ANGELS OF MERCY FOR JD PAIZ INC
Organization’s Mailing Address 2474 FALLS AVE E
City TWIN FALLS
State ID
ZIP 83301
Accounting period End 12
Primary contact name LEROY HAYES CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROSA PAIZ
DIRECTOR
2474 FALLS AVE E
TWIN FALLS ID 83301

Officer/Director/Trustee Two

ERICA HERNANDEZ
DIRECTOR
2474 FALLS AVE E
TWIN FALLS ID 83301

Officer/Director/Trustee Three

CHRISELDA PAIZ
DIRECTOR
4398 S CONSTITUTION AVE
BOISE ID 83716

Officer/Director/Trustee Four

LEROY HAYES
POWER OF ATTORNEY
1150 EASTLAND DR N
TWIN FALLS ID 83301

Organization’s website NA
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/27/2015
Organization Incorporation State ID
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
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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