FORM 1023-EZ for NRV YOUNG ADULT SANCUARY INC

Field Data
EIN 86-3961101
Case Number EO-2021223-000324
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NRV YOUNG ADULT SANCUARY INC
Organization’s Mailing Address 1409 MOUNT TABOR ROAD
City BLACKSBURG
State VA
ZIP 24060
Accounting period End 12
Primary contact name ERIKA LEONGUERRERO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ERIKA LEONGUERRERO
FOUNDER & PRES & DIR
1409 MOUNT TABOR ROAD
BLACKSBURG VA 24060

Officer/Director/Trustee Two

LAWSON KOEPPEL
TREASURER & DIRECTOR
622 ALLISON AVENUE SW 3
ROANOKE VA 24016

Officer/Director/Trustee Three

JOSEPH BROWN
SECRETARY & DIRECTOR
2625 JOHNSTOWN ROAD
CHESAPEAKE VA 23322

Officer/Director/Trustee Four

DAVID FILER
DIRECTOR
251 BUCKINGHAM COURT
ROANOKE VA 24019

Officer/Director/Trustee Five

KARL DEWITT
DIRECTOR
1909 BLENHEIM RD SW
ROANOKE VA 24015

Organization’s website WWW.NRVYAS.ORG
Organization’s email ERIKALG@NRVYAS.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/1/2021
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P73 - Group Home (Long Term)
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ERIKA LEONGUERRERO
Signature Title FOUNDER & PRES & DIR
Signature Date 8/9/2021

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