FORM 1023-EZ for HERITAGE FOSTER FAMILY AGENCY

Field Data
EIN 81-1584005
Case Number EO-2016088-000613
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HERITAGE FOSTER FAMILY AGENCY
Organization’s Mailing Address 1127 NORTH LINWOOD
City VISALIA
State CA
ZIP 93291
Accounting period End 12
Primary contact name GALE KUNS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GALE KUNS
DIRECTOR AND PRESIDENT
1127 N LINWOOD
VISALIA CA 93291

Officer/Director/Trustee Two

RAY RHOE
DIRECTOR AND TREASURER
1297 EAST 600 SOUTH
NEW HARMONY UT 84757

Officer/Director/Trustee Three

JIM HODGES
DIRECTOR AND SECRETARY
131 SOUTH 2460 WEST
HURRICANE UT 84737

Organization’s website WWW.SHORTCREEKFAMILYSERVICES.COM
Organization’s email GKUNS@KUNS.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/14/2015
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P62 - Victims' Services
Organization’s purpose Charitable: Yes
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 Yes
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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