FORM 1023-EZ for COLLATERAL KARMA INC

Field Data
EIN 82-3739223
Case Number EO-2018051-000086
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COLLATERAL KARMA INC
Organization’s Mailing Address 7024 E 6TH ST 103
City SCOTTSDALE
State AZ
ZIP 85251
Accounting period End 12
Primary contact name SUSAN LANE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SUSAN LANE
EXECUTIVE DIRECTOR
7024 E 6TH ST 103
SCOTTSDALE AZ 85251

Officer/Director/Trustee Two

LEWIS LANE
TREASURER
1119 W WAGNER DR
GILBERT AZ 85233

Officer/Director/Trustee Three

SHARLA LANE
SECRETARY
1227 REED AVE
SAN DIEGO CA 92109

Organization’s website WWW.COLLATERALKARMA.ORG
Organization’s email SUSAN@COLLATERALKARMA.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/11/17
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P01 - 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 Yes
Conducting Activities Outside of United States Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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 SUSAN LANE
Signature Title EXECUTIVE DIRECTOR
Signature Date 2/15/18

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