FORM 1023-EZ for VICTIMS SAFE HARBOR FOUNDATION INC

Field Data
EIN 81-2751514
Case Number EO-2016148-000265
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name VICTIMS SAFE HARBOR FOUNDATION INC
Organization’s Mailing Address 23407 SUNSET VIEW
City SORRENTO
State FL
ZIP 32776
Accounting period End 12
Primary contact name JERRELL DAYTON KING
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JERRELL KING
PRESIDENT/DIRECTOR
23407 SUNSET VIEW
SORRENTO FL 32776

Officer/Director/Trustee Two

DONNA KING
SECRETARY/DIRECTOR
23407 SUNSET VIEW
SORRENTO FL 32776

Officer/Director/Trustee Three

LINDA ROBINSON
DIRECTOR
23407 SUNSET VIEW
SORRENTO FL 32776

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/23/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I71 - Spouse Abuse, Prevention of
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 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 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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