FORM 1023-EZ for PJS SAFE HAVEN
| Field | Data |
|---|---|
| EIN | 86-2721365 |
| Case Number | EO-2021099-001203 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | PJS SAFE HAVEN |
| Organization’s Mailing Address | 848 EAST 185TH |
| City | CLEVELAND |
| State | OH |
| ZIP | 44119 |
| Accounting period End | 3 |
| Primary contact name | GARNETTA WILLIAMS |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
GARNETTA WILLIAMS
CEO
18111 MARCELLA ROAD
CLEVELAND OH 44119
Officer/Director/Trustee Two
TYYONNA DAVIS
DIRECTOR
18111 MARCELLA ROAD
CLEVELAND OH 44119
Officer/Director/Trustee Three
CANDICE SCALES
CFO
1311 EAST 117TH
CLEVELAND OH 44106-1403
Officer/Director/Trustee Four
ALAYCIA CLARK
MEDIA SPECIALIST
245 BRENTWOOD DRIVE
PAINESVILLE OH 44077
Officer/Director/Trustee Five
DONETTA TAYLOR
INTAKE SPECIALIST
20 LEONARD AVENUE
BEDFORD OH 44146-2664
| Organization’s website | |
|---|---|
| Organization’s email | PJSSAFEHAVEN@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 1/6/2021 |
| Organization Incorporation State | OH |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P40 - Family 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 | GARNETTA WILLIAMS |
| Signature Title | CEO |
| Signature Date | 3/18/2021 |
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