FORM 1023-EZ for AGAPE HOUSE SOBER LIVING FOR MEN

Field Data
EIN 87-1317736
Case Number EO-2021175-000273
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AGAPE HOUSE SOBER LIVING FOR MEN
Organization’s Mailing Address 340 S LOCKBURN ST
City INDIANAPOLIS
State IN
ZIP 46241
Accounting period End 12
Primary contact name MIKE JAJUGA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MIKE JAJUGA
PRESIDENT
338 S LOCKBURN ST
CHOOSE CITY IN 46241

Officer/Director/Trustee Two

MARY KIRKMAN
VICE PRESIDENT
5139 MCFARLAND RD
INDIANAPOLIS IN 46227

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/2021
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F22 - Alcohol, Drug Abuse, Treatment Only
Organization’s purpose Charitable: No
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 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 MIKE JAJUGA
Signature Title PRESIDENT
Signature Date 6/22/2021

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