FORM 1023-EZ for SHIFT SOCIAL IMPACT

Field Data
EIN 81-2982366
Case Number EO-2021026-000255
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHIFT SOCIAL IMPACT
Organization’s Mailing Address 824 W GURLEY ST
City PRESCOTT
State AZ
ZIP 86305
Accounting period End 12
Primary contact name SARA MASON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SARA MASON
BOARD PRESIDENT
824 W GURLEY ST
PRESCOTT AZ 86305

Officer/Director/Trustee Two

SHANNON THOMPSON
SECRETARY
1897 TIMBER POINT E
PRESCOTT AZ 86305

Officer/Director/Trustee Three

HEATHER PFAHL
BOARD VICE PRESIDENT
3318 BLAINE ST NE
WASHINGTON DC 20019

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/29/2015
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Q32 - International Economic Development
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
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 No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SARA MASON
Signature Title BOARD PRESIDENT
Signature Date 12/5/2020
EIN 81-2982366
Case Number EO-2016176-000142
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SHIFT SOCIAL IMPACT
Organization’s Mailing Address 3300 S GILA
City FLAGSTAFF
State AZ
ZIP 86005
Accounting period End 12
Primary contact name SARA MASON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SARA MASON
PRINCIPAL
3300 S GILA
FLAGSTAFF AZ 86005

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/13/2015
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Q32 - International Economic Development
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 Yes
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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