FORM 1023-EZ for CAVAR FAMILY CANCER FOUNDATION

Field Data
EIN 81-4998955
Case Number EO-2017019-000451
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CAVAR FAMILY CANCER FOUNDATION
Organization’s Mailing Address 11868 S SCENIC COVE
City HERRIMAN
State UT
ZIP 84096
Accounting period End 12
Primary contact name SHANE SIDDOWAY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JESSICA SMALL
DIRECTOR
11868 S SCENIC COVE
HERRIMAN UT 84096

Officer/Director/Trustee Two

DANIEL CAVAR
DIRECTOR
11868 S SCENIC COVE
HERRIMAN UT 84096

Officer/Director/Trustee Three

SHANE SIDDOWAY
FINACIAL OFFICER
1235 W SOUTH MEADOW CIR
SOUTH JORDAN UT 84095

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/17/2017
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H30 - Cancer Research
Organization’s purpose Charitable: Yes
Religious: No
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 Yes
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 No
One Third Support Gifts Yes
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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