FORM 1023-EZ for UTAH ASSOCIATION OF HEALTHCARE VOLUNTEER ORGANIZATION

Field Data
EIN 83-0511438
Case Number EO-2016190-000123
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name UTAH ASSOCIATION OF HEALTHCARE VOLUNTEER ORGANIZATION
Organization’s Mailing Address 2180 SOUTH 1300 EAST STE 440
City SALT LAKE CITY
State UT
ZIP 84106-2813
Accounting period End 9
Primary contact name CAROL ROMNEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANN BITTON
PRESIDENT
2432 S 3775 W
OGDEN UT 84401

Officer/Director/Trustee Two

ROSELYN WOOLFENDEN
PRESIDENT ELECT
9493 KSEL DR
SANDY UT 84092

Officer/Director/Trustee Three

KARLA LOTT
SECRETARY
5594 SOUTH 3450 W
ROY UT 84067

Officer/Director/Trustee Four

CAROL ROMNEY
TREASURER
212 E PEACHTREE DR
CENTERVILLE UT 84014

Officer/Director/Trustee Five

MYRNA NELSON
PAST PRESIDENT
660 S 800 E
BOUNTIFUL UT 84010

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/29/2008
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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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