FORM 1023-EZ for ALPHA HOUSE ASSISTED LIVING FACILITY-TRANSITIONAL HOUSING INC

Field Data
EIN 38-3815171
Case Number EO-2014316-000157
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ALPHA HOUSE ASSISTED LIVING FACILITY-TRANSITIONAL HOUSING INC
Organization’s Mailing Address PO BOX 13844
City ST PETERSBURG
State FL
ZIP 33733
Accounting period End 12
Primary contact name RENEE LEE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RENEE LEE
CEO
2675 22ND AVE S
ST PETERSBURG FL 33712

Officer/Director/Trustee Two

KATHY SULLIVAN
RESIDENTIAL MANAGER
3453 16TH AVENUE N
ST PETERSBURG FL 33713

Officer/Director/Trustee Three

LORRAINE MCNEIL
CHAIRMAN
1165 MACFARLANE AVENEUE
SPRINGHILL FL 34608

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/3/2010
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L41 - Homeless, Temporary Shelter For
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 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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