FORM 1023-EZ for CASSIDYS ANIMAL RECOVERY KAMP OF GRACE

Field Data
EIN 84-2119941
Case Number EO-2021063-000425
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CASSIDYS ANIMAL RECOVERY KAMP OF GRACE
Organization’s Mailing Address PO BOX 2134
City SHINGLE SPRINGS
State CA
ZIP 95682
Accounting period End 12
Primary contact name KERI L BRANSOM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KERI BRANSOM
PRESIDENT
3776 MANY OAKS LANE
SHINGLE SPRINGS CA 95682

Officer/Director/Trustee Two

LINDA HOLLINSWORTH
TREASURER
330 WEST D STREET
TEHACHAPI CA 95361

Officer/Director/Trustee Three

LINETTE COLLINS
SECRETARY
6521 BROWNS RD
PLACERVILLE CA 95667

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/15/2019
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: Yes
Religious: No
Educational: Yes
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 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 Yes
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 KERI BRANSOM
Signature Title PRESIDENT
Signature Date 12/28/2020

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