FORM 1023-EZ for EAGLE HAVEN INCORPORATED

Field Data
EIN 84-3781954
Case Number EO-2021027-000335
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EAGLE HAVEN INCORPORATED
Organization’s Mailing Address 7405 ADMIRAL DRIVE
City ALEXANDRIA
State VA
ZIP 22307
Accounting period End 12
Primary contact name JUSTYNA ZUCHMANSKA CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PETER MICHEL
PRESIDENT/TREASURER/DIRECTOR
1109 GATEWOOD DRIVE
ALEXANDRIA VA 22307

Officer/Director/Trustee Two

MARY JAY MICHEL
VICE PRESIDENT/DIRECTOR
1109 GATEWOOD DRIVE
ALEXANDRIA VA 22307

Officer/Director/Trustee Three

NANCY PENFIELD BURNETT
SECRETARY/DIRECTOR
7405 ADMIRAL DRIVE
ALEXANDRIA VA 22307

Officer/Director/Trustee Four

MATT EDWARDS
DIRECTOR
7957 BOLING DRIVE
ALEXANDRIA VA 22308

Organization’s website
Organization’s email THESBGROUP@ICLOUD.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/6/2019
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C60 - Environmental Education and Outdoor Survival Programs
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 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 No
One Third Support Public No
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 PETER MICHEL
Signature Title PRESIDENT/TREASURER/DIRECTOR
Signature Date 12/7/2020

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