FORM 1023-EZ for DREAM HOME ORPHANAGE INC

Field Data
EIN 46-0920114
Case Number EO-2017240-000207
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DREAM HOME ORPHANAGE INC
Organization’s Mailing Address 22984 CARMELLA RD NW
City POULSBO
State WA
ZIP 98370
Accounting period End 12
Primary contact name NAVEEN CHAUDHARY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NAVEEN CHAUDHARY
PRESIDENT
22984 CARMELLA RD NW
POULSBO WA 98370

Officer/Director/Trustee Two

DONALD JUKAM
DIRECTOR
18077 SUNRISE RIDGE AVE NE
POULSBO WA 98370

Officer/Director/Trustee Three

BONNIE PEDERSON
SECRETARY
1205 SAWDUST HILL RD
POULSBO WA 98370

Officer/Director/Trustee Four

CHARLES WEAVER
TREASURER
20837 KASTER RD NW
POULSBO WA 98370

Officer/Director/Trustee Five

ELAINE JUKAM
DIRECTOR
18077 SUNRISE RIDGE AVE NE
POULSBO WA 98370

Organization’s website NONE
Organization’s email ONETIGER@HOTMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/30/2012
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
One Third Support Public No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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