FORM 1023-EZ for AMOS SUPPORTIVE HOUSING ASSOICATION

Field Data
EIN 83-3194353
Case Number EO-2019331-000286
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AMOS SUPPORTIVE HOUSING ASSOICATION
Organization’s Mailing Address 1150 NORTH 25TH ST STE D
City GRAND JUNCTION
State CO
ZIP 81501-6561
Accounting period End 12
Primary contact name JAMIE ECKERT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMIE ECKERT
DIRECTOR
1150 NORTH 25TH ST STE D
GRAND JUNCTION CO 81501-6561

Officer/Director/Trustee Two

ALLIE BORELL
OFFICER
1150 NORTH 25TH ST STE D
GRAND JUNCTION CO 81501-6561

Officer/Director/Trustee Three

MAE MACENTIRE
OFFICER
1150 NORTH 25TH ST STE D
GRAND JUNCTION CO 81501-6561

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/26/19
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E50 - Rehabilitative Medical Services
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 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 JAMIE ECKERT
Signature Title DIRECTOR
Signature Date 11/25/19

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