FORM 1023-EZ for AUTUMNS HOUSE INC

Field Data
EIN 82-3346646
Case Number EO-2018057-000342
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AUTUMNS HOUSE INC
Organization’s Mailing Address P O BOX 2715
City UPPER DARBY
State PA
ZIP 19082
Accounting period End 12
Primary contact name JEANNETTE DORSEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEANNETTE DORSEY
PRESIDENT
P O BOX 2715
UPPER DARBY PA 19082

Officer/Director/Trustee Two

ANGELA GERMANY
VICE PRESIDENT
P O BOX 2715
UPPER DARBY PA 19082

Officer/Director/Trustee Three

TYEESHA PATTERSON
SECRETARTY
P O BOX 2715
UPPER DARBY PA 19082

Officer/Director/Trustee Four

BRIAN PITTMAN
TREASURER
P O BOX 2715
UPPER DARBY PA 19082

Organization’s website WWW.AUTUMNSHOUSE.ORG
Organization’s email INFO@AUTUMNSHOUSE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/19/18
Organization Incorporation State PA
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: 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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JEANNETTE DORSEY
Signature Title PRESIDENT
Signature Date 2/22/18

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