FORM 1023-EZ for CENTER HOUSE TRANSITION FACILITY

Field Data
EIN 81-0773677
Case Number EO-2016042-000112
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CENTER HOUSE TRANSITION FACILITY
Organization’s Mailing Address 2410 STANTON DR
City PIERRE
State SD
ZIP 57501
Accounting period End 12
Primary contact name JACK BENJAMIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JACK BENJAMIN
PRESIDENT
2008 BUFFALO ST
PIERRE SD 57501

Officer/Director/Trustee Two

STEVE KOHLER
SECRETARY/TREASURER
811 NORTH HARNEY CT
PIERRE SD 57501

Officer/Director/Trustee Three

MARJE STUWE
BOARD MEMBER
1026 NORTH HURON AVE
PIERRE SD 57501

Officer/Director/Trustee Four

DAN PARK
BOARD MEMBER
110 SOUTH ADAMS ST
PIERRE SD 57501

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/2/2015
Organization Incorporation State SD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P72 - Half-Way House (Short-Term Residential Care)
Organization’s purpose Charitable: Yes
Religious: Yes
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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