FORM 1023-EZ for AGAPE HOME

Field Data
EIN 37-1863984
Case Number EO-2017215-000156
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AGAPE HOME
Organization’s Mailing Address 10513 CONVERSE RD
City COULTERVILLE
State CA
ZIP 95311
Accounting period End 7
Primary contact name TRACIE BAUGHN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TRACIE BAUGHN
DIRECTOR
10513 CONVERSE RD
COULTERVILLE AZ 95311

Officer/Director/Trustee Two

JANETTE REHLING
CO-DIRECTOR
9703 MANZANITA WY
COULTERVILLE CA 95311

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/11/2017
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I72 - Child Abuse, Prevention of
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 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
Signature Title
Signature Date

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