FORM 1023-EZ for BRAVO HOUSE INCORPORATED

Field Data
EIN 83-4234087
Case Number EO-2019094-000215
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BRAVO HOUSE INCORPORATED
Organization’s Mailing Address 103 HILL STREET
City TONAWANDA
State NY
ZIP 14150
Accounting period End 4
Primary contact name DEREK ROBERTS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEREK ROBERTS
PRESIDENT
103 HILL STREET
TONAWANDA NY 14150-1000

Officer/Director/Trustee Two

MICHELLE ROBERTS
TREASURER
103 HILL STREET
TONAWANDA NY 14150-1000

Officer/Director/Trustee Three

ROLF CHRISTENSEN
VICE-PRESIDENT
132B FOXBERRY DRIVE
GETZVILLE NY 14068

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/25/19
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F20 - Alcohol, Drug and Substance Abuse, Dependency Prevention and Treatment
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 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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DEREK ROBERTS
Signature Title PRESIDENT
Signature Date 4/2/19

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