FORM 1023-EZ for HUMANE SOCIETY OF SEVIER COUNTY INC

Field Data
EIN 62-1693669
Case Number EO-2016006-000251
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HUMANE SOCIETY OF SEVIER COUNTY INC
Organization’s Mailing Address PO BOX 872
City DE QUEEN
State AR
ZIP 71832
Accounting period End 12
Primary contact name JUANNELLE GAGE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JUANNELLE GAGE
PRESIDENT
112 WESSON LANE
DE QUEEN AR 71832

Officer/Director/Trustee Two

MARK SHORTRIDGE
VP
CHAPEL HILL ROAD
DE QUEEN AR 71832

Officer/Director/Trustee Three

JENNIFER SHORTRIDGE
SEC
CHAPEL HILL ROAD
DE QUEEN AR 71832

Officer/Director/Trustee Four

MARTHA FINES
TREAS
671 SYCAMORE ROAD
DE QUEEN AR 71832

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/19/1997
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: 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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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