FORM 1023-EZ for ST HAVEN ACADEMY INC

Field Data
EIN 85-1935075
Case Number EO-2020209-000627
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ST HAVEN ACADEMY INC
Organization’s Mailing Address 755 EARLHAM DRIVE
City JOHNS CREEK
State GA
ZIP 30024
Accounting period End 12
Primary contact name SHADE DIXON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ASHLEY BOWEN
CHAIR/PRESIDENT
755 EARLHAM DRIVE
JOHNS CREEK GA 30024

Officer/Director/Trustee Two

NORMAN PRINGLE
TREASURER
1070 CREEK RIDGE POINTE
ALPHARETTA GA 30005

Officer/Director/Trustee Three

FELICIA HANNON-WHITE
SECRETARY
6082 INDIAN WOOD CIRCLE
MABLETON GA 30126

Officer/Director/Trustee Four

DEMARCUS AIKENS
DIRECTOR
2390 MANOR OAK COURT
BUFORD GA 30519

Officer/Director/Trustee Five

SHUNDRE NEVELS
DIRECTOR
2206 ML KING JR BLVD
TUSCALOOSA AL 35401

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/29/2020
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth Services
Organization’s purpose Charitable: Yes
Religious: No
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 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 ASHLEY BOWEN
Signature Title CHAIR/PRESIDENT
Signature Date 7/20/2020

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