FORM 1023-EZ for COMPANION ANIMAL MEDICAL PROJECT

Field Data
EIN 85-2876037
Case Number EO-2020254-000153
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COMPANION ANIMAL MEDICAL PROJECT
Organization’s Mailing Address 64682 COOK AVE- NO 70
City BEND
State OR
ZIP 97703
Accounting period End 12
Primary contact name JOHANNAH JOHNSON-WEINBERG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHANNAH JOHNSON-WEINBERG
DIRECTOR, PRESIDENT
19720 JADE COURT
BEND OR 97702

Officer/Director/Trustee Two

PATTI MAYFIELD
DIRECTOR, VICE PRESIDENT
18160 COTTONWOOD RD-PMB 705
SUNRIVER OR 97707

Officer/Director/Trustee Three

VALERIE HEMSTREET
DIRECTOR, SECRETARY
833 SW HILL STREET
BEND OR 97702

Officer/Director/Trustee Four

PETER NYE
DIRECTOR, TREASURER
19978 ASPENWOOD ROAD
BEND OR 97702

Officer/Director/Trustee Five

JAIMIE JENSON
DIRECTOR
19978 ASPENWOOD ROAD
BEND OR 97702

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/10/2020
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D01 - Alliance/Advocacy 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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JOHANNAH JOHNSON-WEINBERG
Signature Title DIRECTOR, PRESIDENT
Signature Date 9/7/2020

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