FORM 1023-EZ for FIT HAVEN COMMUNITY CENTER INC

Field Data
EIN 45-5205013
Case Number EO-2015110-000105
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FIT HAVEN COMMUNITY CENTER INC
Organization’s Mailing Address 670 WINTHROP AVE
City NEW HAVEN
State CT
ZIP 06511
Accounting period End 12
Primary contact name MUBARAKAH IBRAHIM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MUBARAKAH IBRAHIM
MEMBER
670 WINTHROP AVE
NEW HAVEN CT 06511

Officer/Director/Trustee Two

ADRIENNE MAYO
CHAIR
670 WINTHROP AVE
NEW HAVEN CT 06511

Officer/Director/Trustee Three

GINA CALDER
VICE-PRESIDENT
670 WINTHROP AVE
NEW CT 06511

Officer/Director/Trustee Four

JOANNE GOLDBLUM
SECRETARY
670 WINTHROP AVE
NEW HAVEN CT 06511

Officer/Director/Trustee Five

CATHY GRAVES
TREASURER
670 WINTHROP AVE
NEW HAVEN CT 06511

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/25/2015
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N30 - Physical Fitness and Community Recreational Facilities
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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