FORM 1023-EZ for WESTERN REPERFUSION
| Field | Data |
|---|---|
| EIN | 83-3793128 |
| Case Number | EO-2019205-000406 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | WESTERN REPERFUSION |
| Organization’s Mailing Address | PO BOX 120 |
| City | ELBERTA |
| State | UT |
| ZIP | 84626 |
| Accounting period End | 12 |
| Primary contact name | CARSON BATEMAN |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
CARSON BATEMAN
PRIMARY OFFICER
6725 S 13650 W
ELBERTA UT 84626
Officer/Director/Trustee Two
JORDAN JONES
SECONDARY OFFICER
2773 COUNTRYSIDE DRIVE
PLACERVILLE CA 95667
Officer/Director/Trustee Three
CHRIS BADGER
TERTIARY DIRECTOR
1733 MURRAY HOLLADAY RD APT C403
HOLLADAY UT 84117
Officer/Director/Trustee Four
NA NA
NA
NA
NA UT 84606
Officer/Director/Trustee Five
NA NA
NA
NA
NA UT 84606
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/24/19 |
| Organization Incorporation State | UT |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E60 - Health Support Services |
| Organization’s purpose | Charitable: Yes Religious: No Educational: Yes Scientific: Yes 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 | CARSON BATEMAN |
| Signature Title | PRIMARY OFFICER |
| Signature Date | 7/22/19 |
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