FORM 1023-EZ for DAVIDS HOPE PREGNANCY LOSS MINISTRY

Field Data
EIN 47-4311302
Case Number EO-2017062-000447
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DAVIDS HOPE PREGNANCY LOSS MINISTRY
Organization’s Mailing Address 417 ALMOND ST
City NAMPA
State ID
ZIP 83653
Accounting period End 12
Primary contact name LENETTE JACKSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RANDY JACKSON
PUBLIC RELATIONS DIRECTOR
112 20TH AVENUE SOUTH
NAMPA ID 83651

Officer/Director/Trustee Two

JAMES ROBLEDO
CHAIRMAN OF THE BOARD
317 SOUTH GRAYS LANE
NAMPA ID 83687

Officer/Director/Trustee Three

STEPHANIE ROBLEDO
TREASURER
317 SOUTH GRAYS LANE
NAMPA ID 83687

Officer/Director/Trustee Four

CYNTHIA HEGGE
ADMINISTRATOR
11512 EL CENTRO
NAMPA ID 83653

Officer/Director/Trustee Five

LENETTE JACKSON
EXECUTIVE DIRECTOR
112 20TH AVENUE SOUTH
NAMPA ID 83651

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/26/2015
Organization Incorporation State ID
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
Organization’s purpose Charitable: Yes
Religious: Yes
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 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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