FORM 1023-EZ for NIA HOUSE

Field Data
EIN 85-2358260
Case Number EO-2020224-000590
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NIA HOUSE
Organization’s Mailing Address 128 S PARLIAMENT WAY
City CLAYTON
State NC
ZIP 27520
Accounting period End 12
Primary contact name SHANIKA HOULDER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHANIKA HOULDER
EXECUTIVE DIRECTOR
128 S PARLIAMENT WAY
CLAYTON NC 27520

Organization’s website
Organization’s email THENIAHOUSESHELTER@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/2020
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L99 - Housing, Shelter N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
Donation of funds Yes
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 Yes
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 SHANIKA HOULDER
Signature Title EXECUTIVE DIRECTOR
Signature Date 8/7/2020

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