FORM 1023-EZ for JUSTIN AND PAMELA WAGNER FOUNDATION

Field Data
EIN 87-2041554
Case Number EO-2021259-000202
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JUSTIN AND PAMELA WAGNER FOUNDATION
Organization’s Mailing Address 2395 CREEKSIDE LN
City LOOMIS
State CA
ZIP 95650
Accounting period End 12
Primary contact name JUSTIN WAGNER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JUSTIN WAGNER
PRES & TREAS & DIR
PO BOX 567
LOOMIS CA 95650

Officer/Director/Trustee Two

PAMELA WAGNER
SECRETARY & DIRECTOR
PO BOX 567
LOOMIS CA 95650

Officer/Director/Trustee Three

DOUGLAS WAGNER
DIRECTOR
945 MORNINGSTAR DR
SONORA CA 95370

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/3/2021
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X12 - Fund Raising and/or Fund Distribution
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JUSTIN WAGNER
Signature Title PRES & TREAS & DIR
Signature Date 9/14/2021

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