FORM 1023-EZ for HOPE AT MIRACLE HOUSE

Field Data
EIN 46-5508034
Case Number EO-2014254-000239
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HOPE AT MIRACLE HOUSE
Organization’s Mailing Address 306 PARK AVENUE
City FORT LUPTON
State CO
ZIP 80621
Accounting period End 12
Primary contact name HEATHER MARHOEFER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BRAYLON ROUP
PRESIDENT
306 PARK AVENUE
FORT LUPTON CO 80621

Officer/Director/Trustee Two

HEATHER MARHOEFER
VICE PRESIDENT
139 PARK AVENUE
FORT LUPTON CO 80621

Officer/Director/Trustee Three

GWEN CERETTO
TREASURER
306 PARK AVENUE
FORT LUPTON CO 80621

Officer/Director/Trustee Four

SUE HUBERT
SECREATRY
1115 3RD STREET
FORT LUPTON CO 80621

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2014
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L41 - Homeless, Temporary Shelter For
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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