FORM 1023-EZ for PROJECT SAFE HAVEN INCORPORATED

Field Data
EIN 11-3558765
Case Number EO-2018031-000140
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PROJECT SAFE HAVEN INCORPORATED
Organization’s Mailing Address 631 JEFFERSON AVENUE
City BROOKLYN
State NY
ZIP 11221
Accounting period End 5
Primary contact name JANINE DOBIE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JANINE DOBIE
EXECUTIVE DIRECTOR
631 JEFFERSON AVENUE
BROOKLYN NY 11221

Officer/Director/Trustee Two

TERRI HANNA
ASISTANT DIRECTOR
457 A MACDONOUGH STREET
BROOKLYN NY 11233

Officer/Director/Trustee Three

SAEEDA THOMAS
TREASURER
292 MACON STREET
BROOKLYN NY 11217

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/31/00
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 Yes
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name JANINE DOBIE
Signature Title EXECUTIVE DIRECTOR
Signature Date 1/28/18

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