FORM 1023-EZ for VIVA CHIHUAHUA SANCTUARY HOSPICE

Field Data
EIN 81-1154483
Case Number EO-2016022-000175
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name VIVA CHIHUAHUA SANCTUARY HOSPICE
Organization’s Mailing Address 4432 NEAL STARKS LANE
City HARDIN
State KY
ZIP 42048
Accounting period End 12
Primary contact name ELMA FAY STARKS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ELMA FAY STARKS
PRESIDENT
4432 NEAL STARKS LANE
HARDIN KY 42048

Officer/Director/Trustee Two

JILL SLAYDEN
VICE-PRESIDENT
1422 MOORES CAMP HWY
BENTON KY 42025

Officer/Director/Trustee Three

ROXANNE FRYMAN
TREASURER
211 HIGH SCHOOL STREET
HARDIN KY 42048

Officer/Director/Trustee Four

VALARIE ENGLAND
SECRETARY
1751 HALE ROAD
MURRAY KY 42071

Organization’s website WWW.VIVACHIHUAHUASANCTUARY.ORG
Organization’s email VIVACHIHUAHUASANCTUARY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/3/2015
Organization Incorporation State KY
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: 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 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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