FORM 1023-EZ for NAVARRO HOUSE TRANSITIONAL LIVING

Field Data
EIN 84-4939982
Case Number EO-2020064-000386
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name NAVARRO HOUSE TRANSITIONAL LIVING
Organization’s Mailing Address 1036 E ADELAIDE DR
City TUCSON
State AZ
ZIP 85719
Accounting period End 12
Primary contact name SUSAN DERRICK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SUSAN DERRICK
DIRECTOR
1036 E ADELAIDE DR
TUCSON AZ

Officer/Director/Trustee Two

MAZEN NABULSI
DIRECTOR
1036 E ADELAIDE DR
TUCSON AZ 85719

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/27/2020
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L25 - Housing Rehabilitation
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 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 SUSAN DERRICK
Signature Title DIRECTOR
Signature Date 3/2/2020

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