FORM 1023-EZ for JRS HAVEN

Field Data
EIN 47-4849715
Case Number EO-2015279-000126
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JRS HAVEN
Organization’s Mailing Address 7207 ANNAPOLIS AVENUE
City LA MESA
State CA
ZIP 91942
Accounting period End 12
Primary contact name ROBERT GREENOGE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROBERT GREENOGE
PRESIDENT
7207 ANNAPOLIS AVENUE
LA MESA CA 91942

Officer/Director/Trustee Two

TERRENCE JOHNSON
TREASURER SECRETARY
7207 ANNAPOLIS AVENUE
LA MESA CA 91942

Officer/Director/Trustee Three

JULIA GREENOGE
DIRECTOR
7207 ANNAPOLIS AVENUE
LA MESA CA 91942

Officer/Director/Trustee Four

RAELONDA GREENOGE
DIRECTOR
7207 ANNAPOLIS AVENUE
LA MESA CA 91942

Officer/Director/Trustee Five

EMILY CUSANO
DIRECTOR
7207 ANNAPOLIS AVENUE
LA MESA CA 91942

Organization’s website
Organization’s email ROBERTGREENOGE@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/18/2015
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L41 - Homeless, Temporary Shelter For
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 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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