FORM 1023-EZ for OAK RESIDENTIAL & TREATMENT CENTERINC

Field Data
EIN 83-3186910
Case Number EO-2019038-000872
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name OAK RESIDENTIAL & TREATMENT CENTERINC
Organization’s Mailing Address 1455 W 27TH AVENUE APT 2
City ANCHORAGE
State AK
ZIP 99503
Accounting period End 12
Primary contact name OREYAL JACQUET
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

OREYAL JACQUET
PRESIDENT
1455 W 27TH AVENUE APT 2
ANCHORAGE AK 99503

Officer/Director/Trustee Two

SHANITA JACQUET
TREASURER
194 RIDGELINE LOOP APT D
ANCHORAGE AK 99501

Officer/Director/Trustee Three

ARIELLE SCOTT
SECRETARY
512 E 13TH AVENUE
ANCHORAGE AK 99501

Officer/Director/Trustee Four

SHANE BANNARBIE
DIRECTOR
4850 BRYN MAWR CT APT 2
ANCHORAGE AK 99508

Officer/Director/Trustee Five

TIFFANY DAVIS
DIRECTOR
6709 LA TIJERA BLVD
LOS ANGELES CA 90045

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/13/19
Organization Incorporation State AK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
Religious: Yes
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 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 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 OREYAL JACQUET
Signature Title PRESIDENT
Signature Date 2/3/19
EIN 83-3186910
Case Number EO-2019038-000872
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name OAK RESIDENTIAL & TREATMENT CENTER INC
Organization’s Mailing Address 1455 W 27TH AVENUE APT 2
City ANCHORAGE
State AK
ZIP 99503
Accounting period End 12
Primary contact name OREYAL JACQUET
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

OREYAL JACQUET
PRESIDENT
1455 W 27TH AVENUE APT 2
ANCHORAGE AK 99503

Officer/Director/Trustee Two

SHANITA JACQUET
TREASURER
194 RIDGELINE LOOP APT D
ANCHORAGE AK 99501

Officer/Director/Trustee Three

ARIELLE SCOTT
SECRETARY
512 E 13TH AVENUE
ANCHORAGE AK 99501

Officer/Director/Trustee Four

SHANE BANNARBIE
DIRECTOR
4850 BRYN MAWR CT APT 2
ANCHORAGE AK 99508

Officer/Director/Trustee Five

TIFFANY DAVIS
DIRECTOR
6709 LA TIJERA BLVD
LOS ANGELES CA 90045

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/13/19
Organization Incorporation State AK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
Religious: Yes
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 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 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 OREYAL JACQUET
Signature Title PRESIDENT
Signature Date 2/3/19

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