FORM 1023-EZ for SHARP COUNTY SAFE NIGHT

Field Data
EIN 86-2635715
Case Number EO-2021217-000363
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SHARP COUNTY SAFE NIGHT
Organization’s Mailing Address 336 HWY 62 WEST
City ASH FLAT
State AR
ZIP 72513
Accounting period End 12
Primary contact name KAREN BAGWELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KAREN BAGWELL
CHIEF EXECUTIVE OFFICER
336 HWY 62 WEST
ASH FLAT AR 72513

Officer/Director/Trustee Two

JOSEPH BARNES
CHAIRPERSON
PO BOX 700
HARDY AR 72542

Officer/Director/Trustee Three

KASEY CATES
TREASURER
10 KELLER LANE
CHEROKEE VILLAGE AR 72529

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/3/2021
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P43 - Family Violence Shelters, Services
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 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 KAREN BAGWELL
Signature Title CHIEF EXECUTIVE OFFICER
Signature Date 8/3/2021

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