FORM 1023-EZ for SERENITY HOME FOR GIRLS

Field Data
EIN 30-1218516
Case Number EO-2020002-000452
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SERENITY HOME FOR GIRLS
Organization’s Mailing Address 4537 CONDOR AVE
City FONTANA
State CA
ZIP 92336-4734
Accounting period End 12
Primary contact name OLIVIA DAVIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

OLIVIA DAVIS
PRESIDENT
4537 CONDOR AVE
FONTANA CA 92336-4734

Officer/Director/Trustee Two

LYTONYA FORD
SECRETARY
4537 CONDOR AVE
FONTANA CA 92336-4734

Officer/Director/Trustee Three

LA SHAWN JACKSON
TREASURER
4537 CONDOR AVE
FONTANA CA 92336-4734

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/22/2019
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O99 - Youth Development N.E.C.
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 OLIVIA DAVIS
Signature Title PRESIDENT
Signature Date 12/31/2019

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