FORM 1023-EZ for COMPANION ANIMAL RESCUE AND REHOME

Field Data
EIN 81-5215025
Case Number EO-2017046-000201
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COMPANION ANIMAL RESCUE AND REHOME
Organization’s Mailing Address 3051 E DIMPLE DELL CIR
City SANDY
State UT
ZIP 84092
Accounting period End 12
Primary contact name WOLFGANG FRANZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DIXIE LOOSLI
TRUSTEE
3051 E DIMPLE DELL CIR
SANDY UT 84092

Officer/Director/Trustee Two

DOUGLAS L COX
TRUSTEE
1338 MILLDALE CT
HENDERSON NV 89002

Officer/Director/Trustee Three

ROBERT H STAUFFER JR
TRUSTEE
2909 W LAMADRE WAY
NORTH LAS VEGAS NV 89031

Officer/Director/Trustee Four

WOLFGANG R FRANZ
TRUSTEE
1896 N LAKE MOUNTAIN RD
EAGLE MOUNTAIN UT 84005

Officer/Director/Trustee Five

MELISSA KAMMEYER
TRUSTEE
6 DAWN HILL DR
SANDY UT 84092

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/2/2017
Organization Incorporation State UT
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: 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 Yes
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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