FORM 1023-EZ for HOMELESS OF AMERICA

Field Data
EIN 82-1385824
Case Number EO-2017229-000345
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HOMELESS OF AMERICA
Organization’s Mailing Address 14226 56TH AVE S
City TUKWILA
State WA
ZIP 98168
Accounting period End 12
Primary contact name ERNEST ROGERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ERNEST ROGERS
PRESIDENT
14226 56TH AVE S
TUKWILA WA 98168

Officer/Director/Trustee Two

ALETEENA MOBLEY
TREASURER
14226 56TH AVE S
TUKWILA WA 98168

Officer/Director/Trustee Three

TONY JONES
SECRETARY
14226 56TH AVE S
TUKWILA WA 98168

Officer/Director/Trustee Four

PHYLLIS MOBLEY
BOARD MEMBER
14226 56TH AVE S
TUKWILA WA 98168

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/12/2017
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 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
Signature Title
Signature Date

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