FORM 1023-EZ for ESCALON COVENANT ENABLING RESIDENCE

Field Data
EIN 20-4461040
Case Number EO-2016123-000377
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ESCALON COVENANT ENABLING RESIDENCE
Organization’s Mailing Address 1155 ESCALON AVENUE
City ESCALON
State CA
ZIP 95320
Accounting period End 6
Primary contact name LARRY PAULSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SUSAN PAULSEN
PRESIDENT
16240 S VAN ALLEN ROAD
ESCALON CA 95320

Officer/Director/Trustee Two

LARRY PAULSEN
TREASURER
16240 S VAN ALLEN ROAD
ESCALON CA 95320

Officer/Director/Trustee Three

SAUNDRA MILLER
SECRETARY
13164 DROGE ROAD
ESCALON CA 95320

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/29/2005
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P82 - Developmentally Disabled Centers, 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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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