FORM 1023-EZ for SAFE HAVEN COMMUNITY MINISTRIES

Field Data
EIN 83-2757954
Case Number EO-2019050-000230
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SAFE HAVEN COMMUNITY MINISTRIES
Organization’s Mailing Address 2260 ROSECRAN CIR
City LA VERGNE
State TN
ZIP 37086
Accounting period End 12
Primary contact name MARCELLA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARCELLA WATTS
PRESIDENT/CEO
2260 ROSECRAN CIRCLE
LAVERGNE TN 37086-2794

Officer/Director/Trustee Two

JOE HINES
INSIDE DIRECTOR
107 WINDMILL POINTE
HENDERSONVILLE TN 20886-1144

Officer/Director/Trustee Three

WESLEY BROWN
CFO
9601 SWALLOW POINT WAY
MONTGOMERY VILLIAGE MD 37075-4885

Officer/Director/Trustee Four

NICOLE WONZI
EXECUTIVE ASSISTANT
373 SOLITUDE CIRCLE
GOODLETTESVILLE TN 37072-1438

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/25/19
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 Yes
Gaming Activity No
Disaster relief assistance Yes
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 MARCELLA WATTS
Signature Title PRESIDENT/CEO
Signature Date 2/14/19

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