FORM 1023-EZ for HUMBLE HAVEN

Field Data
EIN 82-4505532
Case Number EO-2018135-000311
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HUMBLE HAVEN
Organization’s Mailing Address BOX 343
City SPRINGFIELD
State VT
ZIP 5156
Accounting period End 10
Primary contact name CASSANDRA CARTWRIGHT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CASSANDRA CARTWRIGHT
EXECUTIVE DIRECTOR
BOX 343
SPRINGFIELD VT 5156

Officer/Director/Trustee Two

NELSON RAMIREZ
DIRECTOR
BOX 343
SPRINGFIELD VT 5156

Officer/Director/Trustee Three

CALLIE LIEBMANN
DIRECTOR
BOX 343
SPRINGFIELD VT 5156

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/11/16
Organization Incorporation State VT
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: Yes
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 No
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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 CASSANDRA CARTWRIGHT
Signature Title EXECUTIVE DIRECTOR
Signature Date 5/10/18

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