FORM 1023-EZ for MARY HOUSE INC

Field Data
EIN 47-5402502
Case Number EO-2015350-000150
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MARY HOUSE INC
Organization’s Mailing Address 7 GILMORE ST
City UNIONTOWN
State PA
ZIP 15401
Accounting period End 6
Primary contact name SISTER ANNETTE FREY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BARBARA EINLOTH
PRESIDENT
469 MT THOR ROAD
GREENSBURG PA 15601

Officer/Director/Trustee Two

JEAN AUGUSTINE
SECRETARY
7 GILMORE STREET
UNIONTOWN PA 15401

Officer/Director/Trustee Three

JIM SCHUCOLSKY
TREASURER
6582 ROUTE 56 HIGHWAY EAST
HOMER CITY PA 15748

Officer/Director/Trustee Four

ROY SARVER
VICE PRESIDENT
900 CHESS STREET
MONONGAHELA PA 15063

Officer/Director/Trustee Five

ANNETTE FREY
DIRECTOR
7 GILMORE STREET
UNIONTOWN PA 15401

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/1/2015
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L80 - Housing Support Services -- Other
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
Signature Title
Signature Date

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