FORM 1023-EZ for FAUNA HAVEN ANIMAL SANCTUARY

Field Data
EIN 86-3017777
Case Number EO-2021224-000196
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FAUNA HAVEN ANIMAL SANCTUARY
Organization’s Mailing Address 5345 CELT ROAD
City STANDARDSVILLE
State VA
ZIP 22973-3531
Accounting period End 12
Primary contact name JOY COLLINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOY COLLINS
PRESIDENT
5345 CELT ROAD
STANDARDSVILLE VA 22973-3531

Officer/Director/Trustee Two

ADAM COLLINS
VICE PRESIDENT
5345 CELT ROAD
STANDARDSVILLE VA 22973-3531

Officer/Director/Trustee Three

BRYAN CAIN
TREASURER
5345 CELT ROAD
STANDARDSVILLE VA 22973-3531

Officer/Director/Trustee Four

ERICK CLAVIJO
SECRETARY
5345 CELT ROAD
STANDARDSVILLE VA 22973-3531

Officer/Director/Trustee Five

KIMBERLY BERGLUND
DIRECTOR
5345 CELT ROAD
STANDARDSVILLE VA 22973-3531

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/1/2021
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D20 - Animal Protection and Welfare
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
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 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 JOY COLLINS
Signature Title PRESIDENT
Signature Date 8/10/2021

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