FORM 1023-EZ for STELLINA PSYCHIATRIC SERVICE DOGS

Field Data
EIN 85-2209360
Case Number EO-2020216-000632
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name STELLINA PSYCHIATRIC SERVICE DOGS
Organization’s Mailing Address 355 TAPLIN ROAD
City SAINT HELENA
State CA
ZIP 94574-9601
Accounting period End 12
Primary contact name SUZANNE LAVALLEE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SUZANNE LAVALLEE
CHIEF EXECUTIVE OFFICER
355 TAPLIN ROAD
SAINT HELENA CA 94574-9601

Officer/Director/Trustee Two

HILLERY TRIPPE
SECRETARY
4 IVY COURT
YOUNTVILLE CA 94599-1215

Officer/Director/Trustee Three

DR- DAVID GOLD - DVM
TREASURER
584 MAIN STREET
SAINT HELENA CA 94574-2001

Organization’s website WWW.STELLINAPSYCHIATRICSERVICEDOGS.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/15/2020
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D60 - Other Services - Specialty Animals
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 Yes
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 SUZANNE LAVALLEE
Signature Title CHIEF EXECUTIVE OFFICER
Signature Date 7/31/2020

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