FORM 1023-EZ for HIS HOUSE

Field Data
EIN 85-3579834
Case Number EO-2021100-001148
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HIS HOUSE
Organization’s Mailing Address 199 HWY 80
City RODEO
State NM
ZIP 88506
Accounting period End 12
Primary contact name MIKE GADDIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KARL WARD
DIRECTOR
PO BOX 92
RODEO NM 88056

Officer/Director/Trustee Two

WILLIAM MILLER
DIRECTOR
520 E POST OFFICE CANYON RD
RODEO NM 88056

Officer/Director/Trustee Three

MIKE GADDIS
DIRECTOR
1649 E CIELO AZUL WAY
SAN TAN VALLEY AZ 85140

Officer/Director/Trustee Four

LEROY LACY
DIRECTOR
PO BOX 355
ANIMAS NM 88020

Officer/Director/Trustee Five

MARTIN GARMAN
INCORPORATOR
PO BOX 16161
SAN SIMON AZ 85632

Organization’s website WWW.HISHOUSENMAZ.ORG
Organization’s email KWHISHOUSE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/25/2020
Organization Incorporation State NM
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F20 - Alcohol, Drug and Substance Abuse, Dependency Prevention and Treatment
Organization’s purpose Charitable: Yes
Religious: Yes
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 No
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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 No
Correctness Declaration Yes
Signature Name MIKE GADDIS
Signature Title DIRECTOR
Signature Date 3/30/2021

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