FORM 1023-EZ for SAFE HAVENS MINISTRIES INC

Field Data
EIN 81-3312432
Case Number EO-2016253-000462
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SAFE HAVENS MINISTRIES INC
Organization’s Mailing Address 12877 MEAD LANDING COURT
City JACKSONVILLE
State FL
ZIP 32223
Accounting period End 12
Primary contact name LAURIE LYNN BLEDSOE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAURIE BLEDSOE
PRESIDENT
12877 MEAD LANDING COURT
JACKSONVILLE FL 32223

Officer/Director/Trustee Two

DON PHILLIPS
VICE PRESIDENT
10364 TRIPLE CROWN AVENUE
JACKSONVILLE FL 32257

Officer/Director/Trustee Three

ELBERT BLEDSOE
VICE PRESIDENT
12877 MEAD LANDING COURT
JACKSONVILLE FL 32223

Officer/Director/Trustee Four

LAURIE BLEDSOE
SECRETARY
12877 MEAD LANDING COURT
JACKSONVILLE FL 32223

Officer/Director/Trustee Five

LAURIE BLEDSOE
TREASURER
12877 MEAD LANDING COURT
JACKSONVILLE FL 32223

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/20/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L80 - Housing Support Services -- Other
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
Signature Title
Signature Date

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