FORM 1023-EZ for THE SELF-LOVE HOUSE

Field Data
EIN 87-1139131
Case Number EO-2021165-000570
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE SELF-LOVE HOUSE
Organization’s Mailing Address 3401 VINTON ST
City HOPEWELL
State VA
ZIP 23860
Accounting period End 12
Primary contact name ASHLEY GILLIAM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ASHLEY GILLIAM
OFFICER & DIRECTOR
3401 VINTON ST
HOPEWELL VA 23860

Officer/Director/Trustee Two

JENNIFER COOK
OFFICER & DIRECTOR
10376 MONOCAN WAY
ASHLAND VA 23005

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/6/2021
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ASHLEY GILLIAM
Signature Title OFFICER & DIRECTOR
Signature Date 6/11/2021

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