FORM 1023-EZ for CASEYS PLACE

Field Data
EIN 81-3473796
Case Number EO-2016347-000137
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CASEYS PLACE
Organization’s Mailing Address 1018 COUNTY ROAD 143
City KAUFMAN
State TX
ZIP 75142
Accounting period End 12
Primary contact name ROBIN CRUZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBIN CRUZ
PRESIDENT
1018 COUNTY ROAD 143
KAUFMAN TX 75142

Officer/Director/Trustee Two

LINDA ENGLISH
SECRETARY
1003 WILKSWAY
MABANK TX 75147

Officer/Director/Trustee Three

KELLIE COFFEY
VP OF OPERATIONS
16277 COUNTY ROAD 255
TERRELL TX 75160

Organization’s website WWW.CASEYSPLACE.ORG
Organization’s email CASEYSPLACE2012@EMBARQMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/30/2016
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N20 - Recreational and Sporting Camps
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
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
Signature Title
Signature Date

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