FORM 1023-EZ for CRIE HAVEN HOUSE

Field Data
EIN 35-2241319
Case Number EO-2014262-000332
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CRIE HAVEN HOUSE
Organization’s Mailing Address 11 JAMES ST
City ROCKLAND
State ME
ZIP 04841
Accounting period End 6
Primary contact name CELIA PERRY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SANDRA WILLIAMS
PRESIDENT
161 YAMACRAW PL
LEXINGTON KY 40511

Officer/Director/Trustee Two

CELIA PERRY
TREASURER
11 JAMES ST
ROCKLAND ME 04841

Officer/Director/Trustee Three

DAVID POUCHOT
DIRECTOR
2266 BELFAST RD
LINCOLNVILLE ME 04849

Officer/Director/Trustee Four

MARIAN POUCHOT
DIRECTOR
2266 BELFAST RD
LINCOLNVILLE ME 04849

Officer/Director/Trustee Five

EUGENE DILORENZO
DIRECTOR
870 BARNESTONE RD
HOPE ME 04847

Organization’s website CRIEHAVENMINISTRIES.ORG
Organization’s email CELIAP@MIDCOAST.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/5/2004
Organization Incorporation State ME
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L40 - Low-Cost Temporary Housing
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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