FORM 1023-EZ for WESTFALL C A R E S

Field Data
EIN 82-2870524
Case Number EO-2018038-000283
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WESTFALL C A R E S
Organization’s Mailing Address 16394 TURNEY CALDWELL ROAD
City CIRCLEVILLE
State OH
ZIP 43113-9549
Accounting period End 12
Primary contact name KATHERINE FAUSNAUGH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KATHERINE FAUSNAUGH
PRESIDENT, DIRECTOR
16394 TURNEY CALDWELL RD
CIRCLEVILLE OH 43164-9549

Officer/Director/Trustee Two

DAWN FINCH
TREASURER, DIRECTOR
12630 CLIFTON ROAD
MOUNT STERLING OH 43143-9024

Officer/Director/Trustee Three

MR LYNN JOHNSON
VICE PRESIDENT, DIRECTOR
3971 HOOVER ROAD 150
GROVE CITY OH 43123-2839

Officer/Director/Trustee Four

KATHERINE MORRIS
SECRETARY, DIRECTOR
14389 STATE ROUTE 56 WEST
MOUNT STERLING OH 43143-9530

Officer/Director/Trustee Five

TAWANA RUTH
FINANCIAL SECRETARY, DIRECTOR
10872 COCHRAN ROAD
WILLIAMSPORT OH 43164-9797

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/23/18
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B11 - Single Organization Support
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 KATHERINE FAUSNAUGH
Signature Title PRESIDENT, DIRECTOR
Signature Date 2/5/18

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