FORM 1023-EZ for FUREVER COMPANION FOUNDATION

Field Data
EIN 83-4176227
Case Number EO-2019253-000161
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FUREVER COMPANION FOUNDATION
Organization’s Mailing Address 1127 W CARROLL ST
City MACOMB
State IL
ZIP 61455
Accounting period End 12
Primary contact name MICHAEL G WAACK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL WAACK
PRESIDENT
1127 W CARROLL ST
MACOMB IL 61455-1913

Officer/Director/Trustee Two

EMILY KELLY
VICE PRESIDENT
1127 W CARROLL ST
MACOMB IL 61455-1913

Officer/Director/Trustee Three

CHARLES LOTZ
VETERINARIAN CONSULTANT
823 E JACKSON ST
MACOMB IL 61455-2411

Organization’s website
Organization’s email DAKOTASURFER@DAKOTASURFER.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/3/19
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D12 - 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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MICHAEL WAACK
Signature Title PRESIDENT
Signature Date 9/6/19

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