FORM 1023-EZ for EBENEZER HILL HOUSE

Field Data
EIN 85-3396030
Case Number EO-2021095-000463
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EBENEZER HILL HOUSE
Organization’s Mailing Address PO BOX 1210
City SOUR LAKE
State TX
ZIP 77659
Accounting period End 9
Primary contact name LOREN OLIVER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LANCE RAYON
CEO
PO BOX 1210
SOUR LAKE TX 77659

Officer/Director/Trustee Two

LOREN OLIVER
CEO
PO BOX 1210
SOUR LAKE TX 77659

Officer/Director/Trustee Three

RENEE ELLIS
CEO
PO BOX 1210
SOUR LAKE TX 77659

Officer/Director/Trustee Four

SAMANTHA RAYON
CFO
PO BOX 1210
SOUR ALKE TX 77659

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/10/2020
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I31 - Transitional Care, Half-Way House for Offenders, Ex-Offenders
Organization’s purpose Charitable: No
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 Yes
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
Gaming Activity No
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name LOREN OLIVER
Signature Title CEO
Signature Date 3/7/2021

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