FORM 1023-EZ for ANIMAL WELFARE WEST

Field Data
EIN 47-2030136
Case Number EO-2014287-000311
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ANIMAL WELFARE WEST
Organization’s Mailing Address 550 COUNTY RD 502
City BAYFIELD
State CO
ZIP 81122
Accounting period End 12
Primary contact name BROOKE GROSKOPF
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BROOKE GROSKOPF
PRESIDENT, DIRECTOR
550 COUNTY RD 502
BAYFIELD CO 81122

Officer/Director/Trustee Two

LISA GIRARDOT
SECRETARY, DIRECTOR
558 COUNTY RD 523
BAYFIELD CO 81122

Officer/Director/Trustee Three

MARCY ECKHARDT
TREASURER, DIRECTOR
10 TOWN PLAZA STE 101
DURANGO CO 81301

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/8/2014
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D60 - Other Services - Specialty Animals
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 Yes
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts Yes
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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