FORM 1023-EZ for A DIGNIFIED HOME

Field Data
EIN 82-2859030
Case Number EO-2017272-000221
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name A DIGNIFIED HOME
Organization’s Mailing Address 575 NAPLES APT B
City SAN FRANCISCO
State CA
ZIP 94112
Accounting period End 12
Primary contact name LAUREL HILBERT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAUREL HILBERT
PRESIDENT
575 NAPLES APT B
SAN FRANCISCO CA 94112

Officer/Director/Trustee Two

BEVAN DUFTY
TREASURER
575 NAPLES APT B
SAN FRANCISCO CA 94112

Officer/Director/Trustee Three

MARAEA MASTER
SECRETARY
575 NAPLES APT B
SAN FRANCISCO CA 94112

Organization’s website
Organization’s email LAUREL.HILBERT@ADIGNIFIEDHOME.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/15/2017
Organization Incorporation State CA
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: 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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