FORM 1023-EZ for THE SERENITY HOUSE OF FLINT

Field Data
EIN 47-3384600
Case Number EO-2016021-000461
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE SERENITY HOUSE OF FLINT
Organization’s Mailing Address PO BOX 271
City GRAND BLANC
State MI
ZIP 48480
Accounting period End 12
Primary contact name GORDON GARDNER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RACHEL MORENO
PRESIDENT
120 LAUREL LEAH
FENTON MI 48430

Officer/Director/Trustee Two

BECCA TOWNSEND
VICE PRESIDENT
G-3360 HERRICK STREET
FLINT MI 48532

Officer/Director/Trustee Three

SERENA GUNN
SECRETARY
800 OAK STREET
FLINT MI 48503

Officer/Director/Trustee Four

GORDON GARDNER
TREASURER
372 VICTORY LANE
FLINT MI 48507

Officer/Director/Trustee Five

IRENE KEATING
BOARD MEMBER
PO BOX 249
GOODRICH MI 48438

Organization’s website WWW.FLINTSERENITYHOUSE.ORG
Organization’s email FLINTSERENITYHOUSE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/19/2015
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
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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