FORM 1023-EZ for MISSYS HAVEN

Field Data
EIN 45-2148549
Case Number EO-2016056-000307
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MISSYS HAVEN
Organization’s Mailing Address 11023 KOSUB LANE LOT 2
City SAN ANTONIO
State TX
ZIP 78223
Accounting period End 5
Primary contact name MICHELLE HOLMES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MICHELLE HOLMES
PRESIDENT/DIRECTOR
11023 KOSUB LANE LOT 2
SAN ANTONIO TX 78223

Officer/Director/Trustee Two

VICTORIA PEREZ
DIRECTOR OF OPERATIONS
11023 KOSUB LANE
SAN ANTONIO TX 78223

Officer/Director/Trustee Three

DEBORAH DEGUZMAN
DIRECTOR OF DOG CARE
11023 KOSUB LANE
SAN ANTONIO TX 78223

Officer/Director/Trustee Four

AIMEE LEWIS
EVENTS COORDINATOR
11023 KOSUB LANE
SAN ANTONIO TX 78223

Organization’s website WWW.MISSYSHAVEN.ORG
Organization’s email MISSYSHAVEN45@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/4/2011
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D99 - Animal-Related N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
Unrelated Gross Income $1,000 or More Yes
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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