FORM 1023-EZ for A HOME FOR ROVER INC

Field Data
EIN 85-1936517
Case Number EO-2021083-000183
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name A HOME FOR ROVER INC
Organization’s Mailing Address 2945 REEVES LANE
City LAKEPORT
State CA
ZIP 95453
Accounting period End 7
Primary contact name VAL STALLINGS OR SHELBI WREESMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

VALERI STALLINGS
CEO/CFO
2945 REEVES LANE
LAKEPORT CA 95453

Officer/Director/Trustee Two

SHELBI WREESMAN
CEO/FOUNDER
304 ASHWOOD
VENTURA CA 93003

Officer/Director/Trustee Three

TAYLOR STALLINGS
SECRETARY
2945 REEVES LANE
LAKEPORT CA 95453

Organization’s website N/A
Organization’s email SENDROVER@SBCGLOBAL.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/31/2020
Organization Incorporation State CA
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: Yes
Scientific: Yes
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 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 VALERI STALLINGS
Signature Title CEO/CFO
Signature Date 10/9/2020

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