FORM 1023-EZ for MY SISTERS HOUSE

Field Data
EIN 81-5153227
Case Number EO-2017038-000284
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MY SISTERS HOUSE
Organization’s Mailing Address 837 CAMELIA DRIVE
City MELBOURNE
State FL
ZIP 32901
Accounting period End 12
Primary contact name LUANNA MARTIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LUANNA MARTIN
PRESIDENT
165 LANDING ROAD
MELBOURNE FL 32951

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/21/2016
Organization Incorporation State FL
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 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 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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