FORM 1023-EZ for SENIOR HOUSING MATCH

Field Data
EIN 82-5301402
Case Number EO-2020016-000382
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SENIOR HOUSING MATCH
Organization’s Mailing Address 2704 SHERIDAN AVENUE
City DES MOINES
State IA
ZIP 50310
Accounting period End 12
Primary contact name PAMELA NELSON-GROTRIAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CAROLE NELSON
PRESIDENT
1602 CLINTON AVENUE
BOONE IA 50036

Officer/Director/Trustee Two

MERCY DAS
SECRETARY
78 E 10 STREET
ST. PAUL MN 55101

Officer/Director/Trustee Three

PETER NELSON
TREASURY
1602 CLINTON AVENUE
BOONE IA 50036

Officer/Director/Trustee Four

PAMELA NELSON-GROTRIAN
DIRECTOR
2704 SHERIDAN AVENUE
DES MOINES IA 50310

Organization’s website SENIORHOUSINGMATCH.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/24/2018
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L30 - Housing Search Assistance
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 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 PAMELA NELSON-GROTRIAN
Signature Title DIRECTOR
Signature Date 1/14/2020

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