FORM 1023-EZ for LADY OF THE HOUSE

Field Data
EIN 84-3495593
Case Number EO-2019305-000243
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LADY OF THE HOUSE
Organization’s Mailing Address 9526 ARGYLE FOREST BLVD STE B2-373
City JACKSONVILLE
State FL
ZIP 32222
Accounting period End 12
Primary contact name DEMEATRICE BENTLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEMEATRICE BENTLEY
PRESIDENT
9526 ARGYLE FOREST BLVD STE B2-373
JACKSONVILLE FL 32222

Officer/Director/Trustee Two

JAI NICOLE BENTLEY
BOARD MEMBER
9526 ARGYLE FOREST BLVD STE B2-373
JACKSONVILLE FL 32222

Officer/Director/Trustee Three

JOI GABRIELLE BENTLEY
BOARD MEMBER
9526 ARGYLE FOREST BLVD STE B2-373
JACKSONVILLE FL 32222

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/28/19
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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 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 DEMEATRICE BENTLEY
Signature Title PRESIDENT
Signature Date 10/30/19

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