FORM 1023-EZ for ADOPT A HOME MINISTRY INC

Field Data
EIN 82-5300243
Case Number EO-2018128-000198
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ADOPT A HOME MINISTRY INC
Organization’s Mailing Address 187 SW TIMBER RIDGE DR
City LAKE CITY
State FL
ZIP 32024
Accounting period End 12
Primary contact name MATTHEW WARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MATTHEW WARD
PRESIDENT, TREASURER, DIRECTOR
187 SW TIMBER RIDGE DR
LAKE CITY FL 32024

Officer/Director/Trustee Two

KENNETH RYE
SECRETARY, DIRECTOR
328 SW 34TH ST APT 15
GAINESVILLE FL 32607

Officer/Director/Trustee Three

WILLIAM RYE
DIRECTOR
4808 NW 79TH RD
GAINESVILLE FL 32653

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/13/18
Organization Incorporation State FL
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: Yes
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 MATTHEW WARD
Signature Title PRESIDENT, TREASURER, DIRECTOR
Signature Date 4/30/18

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