FORM 1023-EZ for ROOTED AMERICAN

Field Data
EIN 81-4626069
Case Number EO-2021273-000181
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ROOTED AMERICAN
Organization’s Mailing Address 4015 COUNTY ROAD 4760
City SULPHUR SPRINGS
State TX
ZIP 75482
Accounting period End 12
Primary contact name SHELLY CALDERON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHELLY CALDERON
PRESIDENT
400 CR 4759
SULPHUR SPRINGS TX 75482

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents No
Organization Incorporation Date 11/8/2016
Organization Incorporation State NV
Contains Limitation No
Does not expressly empower No
Contains dissolution No
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration No
Signature Name SHELLY CALDERON
Signature Title PRESIDENT
Signature Date 9/28/2021
EIN 81-4626069
Case Number EO-2017068-000386
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ROOTED AMERICAN
Organization’s Mailing Address 10325 LETTUCE LEAF
City LAS VEGAS
State NV
ZIP 89183
Accounting period End 12
Primary contact name BRIAN HIGHLAND JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRIAN HIGHLAND JR
PRESIDENT
10325 LETTUCE LEAF
LAS VEGAS NV 89183

Officer/Director/Trustee Two

BRIAN HIGHLAND JR
SECRETARY
10325 LETTUCE LEAF
LAS VEGAS NV 89183

Officer/Director/Trustee Three

BRIAN HIGHLAND JR
TREASURER
10325 LETTUCE LEAF
LAS VEGAS NV 89183

Officer/Director/Trustee Four

BRIAN HIGHLAND JR
DIRECTOR
10325 LETTUCE LEAF
LAS VEGAS NV 89183

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/7/2016
Organization Incorporation State NV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W30 - Military, Veterans' Organizations
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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