FORM 1023-EZ for FARM ANIMAL REFUGE

Field Data
EIN 81-3965083
Case Number EO-2016278-000193
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FARM ANIMAL REFUGE
Organization’s Mailing Address 33233 SHOCKEY TRUCK TRAIL
City CAMPO
State CA
ZIP 91906
Accounting period End 12
Primary contact name JORDAN RUSSO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JORDAN RUSSO
PRESIDENT
33233 SHOCKEY TRUCK TRAIL
CAMPO CA 91906

Officer/Director/Trustee Two

MATTHEW LIEURANCE
TREASURER
33233 SHOCKEY TRUCK TRAIL
CAMPO CA 91906

Officer/Director/Trustee Three

JOHN RUSSO
SECRETARY
9212 LAKE HILL RD
SANTEE CA 92071

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/13/2016
Organization Incorporation State CA
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: No
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 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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