FORM 1023-EZ for APPALACHIA MISSION PAWSIBLE

Field Data
EIN 35-2656321
Case Number EO-2019112-000562
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name APPALACHIA MISSION PAWSIBLE
Organization’s Mailing Address 109 PINE ST
City CHURCH HILL
State TN
ZIP 37642
Accounting period End 12
Primary contact name JAMIE FARRIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMIE FARRIS
PRESIDENT
109 PINE ST
CHURCH HILL TN 37642

Officer/Director/Trustee Two

ERICKA GAMBLE
VICE PRESIDENT
110 A HOBART HYDER DR 9
ELIZABETHTON TN 37643

Officer/Director/Trustee Three

STACEY HEIDEN
SECRETARY
126 RUNION ST
ELIZABETHTON TN 37643

Officer/Director/Trustee Four

KAREN WRIGHT
TREASURER
13212 MELINA LANE
BRISTOL VA 24203

Officer/Director/Trustee Five

Jamie Farris

109 Pine St Church Hill
TN

Organization’s website WWW.AMPAWSIBLE.COM
Organization’s email AMPAWSIBLE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/19
Organization Incorporation State TN
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: No
Religious: No
Educational: No
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 No
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JAMIE FARRIS
Signature Title PRESIDENT
Signature Date 4/18/19

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