FORM 1023-EZ for PRESERVATION OF REST HAVEN INC

Field Data
EIN 82-0723377
Case Number EO-2017083-000138
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PRESERVATION OF REST HAVEN INC
Organization’s Mailing Address 236 HIGH STREET
City MONROE
State NY
ZIP 10950
Accounting period End 12
Primary contact name GARY SCHUSTER ESQ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICIA TAYLOR
DIRECTOR
69 MOUNTAIN AVENUE
HIGHLAND FALLS NY 10928

Officer/Director/Trustee Two

LAWRENCE KILDUFF
DIRECTOR
3 REVERE CT 2702
SUFFERN NY 10901

Officer/Director/Trustee Three

APRIL MITTS
DIRECTOR
9 LAKE REGION BLVD
MONROE NY 10950

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/21/2017
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A80 - Historical Societies, Related Historical Activities
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 Yes
One Third Support Gifts No
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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