FORM 1023-EZ for GOSHEN HOUSE

Field Data
EIN 86-3562544
Case Number EO-2021123-000249
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GOSHEN HOUSE
Organization’s Mailing Address 3553 ATLANTIC AVE 309
City LONG BEACH
State CA
ZIP 90807
Accounting period End 11
Primary contact name SHALAWN GARCIA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHALAWN GARCIA
PRESIDENT CEO
3553 ATLANTIC AVE 309
LONG BEACH CA 90807

Officer/Director/Trustee Two

SHEREE GARCIA
VP
3313 LAKELAND WAY
ELK GROVE CA 95758

Officer/Director/Trustee Three

TINA BACKSTROM
VP
3553 ATLANTIC AVE 309
LONG BEACH CA 90807

Organization’s website
Organization’s email SHALAWNGARCIA@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/2/2021
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
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 Yes
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 Yes
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 SHALAWN GARCIA
Signature Title PRESIDENT CEO
Signature Date 4/29/2021

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