FORM 1023-EZ for FAIRBORN AGAINST HEROIN
| Field | Data |
|---|---|
| EIN | 47-4847077 |
| Case Number | EO-2016265-000175 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | FAIRBORN AGAINST HEROIN |
| Organization’s Mailing Address | 5545 FAIRFIELD PIKE |
| City | ENON |
| State | OH |
| ZIP | 45323 |
| Accounting period End | 12 |
| Primary contact name | JASON KEGLEY |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
JASON KEGLEY
PRESIDENT
1041 HARVARD AVENUE
FAIRBORN OH 45324
Officer/Director/Trustee Two
JOHN HENDERSON
DIRECTOR OF OPERATIONS
5545 FAIRFIELD PIKE
ENON OH 45323
Officer/Director/Trustee Three
AMBER KNAUB
SECRETARY
1528 GLENDALE DRIVE
FAIRBORN OH 45324
Officer/Director/Trustee Four
DEBRA MATTACHIONE
TREASURER
410 FAIRWAY DRIVE
FAIRBORN OH 45324
Officer/Director/Trustee Five
DAVID THRASHER
PUBLIC RELATIONS OFFICER
3357 BOXWOOD DRIVE
FAIRBORN OH 45324
| Organization’s website | FAHRECOVERY.COM |
|---|---|
| Organization’s email | INFO@FAIRBORNAGAINSTHEROIN.ORG |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/2/2015 |
| Organization Incorporation State | OH |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | F99 - Mental Health, Crisis Intervention N.E.C. |
| Organization’s purpose | Charitable: Yes Religious: No Educational: Yes Scientific: Yes Literary: No Public Safety: No Amateur Sports: No Cruelty Prevention: No |
| Qualify For Exemption | No |
| Legislation influence | Yes |
| 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 | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | |
| Signature Title | |
| Signature Date |
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