FORM 1023-EZ for HENRY COUNTY ANIMAL INITIATIVE

Field Data
EIN 84-3267902
Case Number EO-2019297-000425
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HENRY COUNTY ANIMAL INITIATIVE
Organization’s Mailing Address 502 HOLLY OAK WAY
City MCDONOUGH
State GA
ZIP 30253
Accounting period End 12
Primary contact name JENNIFER EVANS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JENNIFER EVANS
DIRECTOR/PRESIDENT
502 HOLLY OAK WAY
MCDONOUGH GA 30253

Officer/Director/Trustee Two

BOBBIE HANCOCK
DIRECTOR/VICE PRESIDENT
270 COADY ROAD
JACKSON GA 30233

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/26/19
Organization Incorporation State GA
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 JENNIFER EVANS
Signature Title DIRECTOR/PRESIDENT
Signature Date 10/22/19

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