FORM 1023-EZ for ANIMAL WELLNESS INITIATIVE

Field Data
EIN 83-2221249
Case Number EO-2018317-000277
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ANIMAL WELLNESS INITIATIVE
Organization’s Mailing Address 5309 NW 13TH CIRCLE
City CAMAS
State WA
ZIP 98607
Accounting period End 12
Primary contact name AMANDA KREMER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AMANDA KREMER
DIRECTOR/PRESIDENT
5309 NW 13TH CIRCLE
CAMAS WA 98607

Officer/Director/Trustee Two

ANDREW TORCHIO
DIRECTOR
5309 NW 13TH CIRCLE
CAMAS WA 98607

Officer/Director/Trustee Three

ASHLEY TORCHIO
DIRECTOR
5309 NW 13TH CIRCLE
CAMAS WA 98607

Officer/Director/Trustee Four

NEVIN ROSENBERG
TREASURER/SECRETARY
5309 NW 13TH CIRCLE
CAMAS WA 98607

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/23/18
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion 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 AMANDA KREMER
Signature Title DIRECTOR/PRESIDENT
Signature Date 11/8/18

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