FORM 1023-EZ for PAYNE COUNTY ANIMAL RESPONSE TEAM

Field Data
EIN 47-5661919
Case Number EO-2016146-000083
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PAYNE COUNTY ANIMAL RESPONSE TEAM
Organization’s Mailing Address 713 SOUTH PINE STREET
City STILLWATER
State OK
ZIP 74074
Accounting period End 6
Primary contact name DEBBIE HAMBLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DANIEL BURBA
DIRECTOR
4511 NOBLE ROAD
STILLWATER OK 74075

Officer/Director/Trustee Two

DEBBIE HAMBLE
FINANCE OFFICER
713 SOUTH PINE STREET
STILLWATER OK 74074

Officer/Director/Trustee Three

STACY MASON
CO-DIRECTOR
102 WEST REDBUD DRIVE
STILLWATER OK 74074

Officer/Director/Trustee Four

JILL MURRAY
SECRETARY
4100 WEST 19TH AVENUE E-104
STILLWATER OK 74074

Officer/Director/Trustee Five

JACKIE ROSS-GUERRERO
VOLUNTEER COORDINATOR
709 NORTH STONEY CREEK
STILLWATER OK 74074

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/17/2015
Organization Incorporation State OK
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: 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 No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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
Signature Title
Signature Date

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