FORM 1023-EZ for CAMP KOAH INC

Field Data
EIN 83-3825282
Case Number EO-2019326-000337
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CAMP KOAH INC
Organization’s Mailing Address 13 S WILDFLOWER DRIVE
City ALPINE
State UT
ZIP 84004
Accounting period End 12
Primary contact name LAUREL JONES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GABRIELLE ISRAELSEN
PRESIDENT/DIRECTOR
55 N MEADOWBROOK DRIVE
ALPINE UT 84004

Officer/Director/Trustee Two

LAUREL JONES
VICE PRESIDENT/DIRECTOR
13 S WILDFLOWER DRIVE
ALPINE UT 84004

Officer/Director/Trustee Three

MANDY ADAMS
DIRECTOR
2513 W 30 N
LEHI UT 84043

Organization’s website CAMPKOAH.COM
Organization’s email CAMPKOAH@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/15/19
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth Services
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 GABRIELLE ISRAELSEN
Signature Title PRESIDENT/DIRECTOR
Signature Date 11/20/19

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