FORM 1023-EZ for ANNA SHIRLEYS HOUSE

Field Data
EIN 47-4203432
Case Number EO-2015216-000148
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ANNA SHIRLEYS HOUSE
Organization’s Mailing Address 12000 DESSAU ROAD APT 612
City AUSTIN
State TX
ZIP 78754
Accounting period End 12
Primary contact name FELICIE SPENCER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

FELICIE SPENCER
PRESIDENT
12000 DESSAU ROAD APT 612
AUSTIN TX 78754

Officer/Director/Trustee Two

FELICITY SPENCER
VICE-PRESIDENT
750 FRANKLIN ROAD APT 19F
MARIETTA GA 30067

Officer/Director/Trustee Three

MARIE D SALONE
SECRETARY
3645 GLENWAY
CORPUS CHRISTI TX 78415

Officer/Director/Trustee Four

DERRELL FOSTER
BOARD MEMBER
12427 MARDI GRAS DRIVE
HOUSTON TX 77014

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/22/2015
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
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 Yes
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
Signature Title
Signature Date

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