FORM 1023-EZ for STANLY COUNTY ANIMAL SHELTER

Field Data
EIN 85-2830390
Case Number EO-2020273-000329
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name STANLY COUNTY ANIMAL SHELTER
Organization’s Mailing Address 1037 COBLE AVENUE
City ALBEMARLE
State NC
ZIP 28001
Accounting period End 6
Primary contact name TERESA WHITE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

G DAVID JENKINS
PRESIDENT
1037 COBLE AVENUE
ALBEMARLE NC 28001

Officer/Director/Trustee Two

JACQUELINE DESANTIS
VICE PRESIDENT
1037 COBLE AVENUE
ALBEMARLE NC 28001

Officer/Director/Trustee Three

TERI BOWERS
SECRETARY
1037 COBLE AVENUE
ALBEMARLE NC 28001

Officer/Director/Trustee Four

CHARLES HARTSELL
TREASURER
1037 COBLE AVENUE
ALBEMARLE NC 28001

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/23/2020
Organization Incorporation State NC
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 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 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 G DAVID JENKINS
Signature Title PRESIDENT
Signature Date 9/25/2020

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