FORM 1023-EZ for CAL HAZE

Field Data
EIN 84-2769019
Case Number EO-2019322-000375
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CAL HAZE
Organization’s Mailing Address 1108 CIELO CIRCLE
City ROHNERT PARK
State CA
ZIP 94928
Accounting period End 12
Primary contact name DEAN MERRILL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEAN MERRILL
PRESIDENT/DIRECTOR
1108 CIELO CIRCLE
ROHNERT PARK CA 94928

Officer/Director/Trustee Two

MICHAEL HALL
TREASURER/DIRECTOR
739 FIFTH STREET WEST
SONOMA CA 95476

Officer/Director/Trustee Three

CHRIS HOKE
SECRETARY/DIRECTOR
1108 CIELO CIRCLE
ROHNERT PARK CA 94928

Organization’s website
Organization’s email MR948CC@COMCAST.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 DEAN MERRILL
Signature Title PRESIDENT/DIRECTOR
Signature Date 11/15/19

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