FORM 1023-EZ for HAVEN HILL RESIDENTIAL

Field Data
EIN 85-3196847
Case Number EO-2021095-000553
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HAVEN HILL RESIDENTIAL
Organization’s Mailing Address 2711 BATSON AVE
City ROWLAND HEIGHTS
State CA
ZIP 91748
Accounting period End 12
Primary contact name ROSEANNE H PEREZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROSEANNE PEREZ
PRESIDENT/DIRECTOR/OWNER
2711 BATSON AVE
ROWLAND HEIGHTS CA 91748

Officer/Director/Trustee Two

ANTHONY PEREZ
TREASURER/DIRECTOR
2711 BATSON AVE
ROWLAND HEIGHTS CA 91748

Officer/Director/Trustee Three

CHRISTINA CONTRERAS
SECRETARY/DIRECTOR
2208 W 8TH ST
LOS ANGELES CA 90057

Organization’s website
Organization’s email ROSEANNEHPEREZ@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/15/2020
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F33 - Group Home, Residential Treatment Facility - Mental Health Related
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 Yes
Donation of funds Yes
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 ROSEANNE PEREZ
Signature Title PRESIDENT/DIRECTOR/OWNER
Signature Date 3/5/2021

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