FORM 1023-EZ for CHANNAH HOUSE OF FAVOR & GRACE CORP

Field Data
EIN 87-2191460
Case Number EO-2021253-000211
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHANNAH HOUSE OF FAVOR & GRACE CORP
Organization’s Mailing Address 7972 PINES BLVD
City PEMBROKES PINES
State FL
ZIP 33024
Accounting period End 8
Primary contact name KELLIE DENIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELLIE DENIS
PRESIDENT
7972 PINES BLVD
PEMBROKE PINES FL 33024

Officer/Director/Trustee Two

MITSOUKA SEMEXANT
OFFICER
7972 PINES BLVD
PEMBROKE PINES FL 33024

Officer/Director/Trustee Three

MARIE M LADOUCEU
OFFICER
7972 PINES BLVD
PEMBROKE PINES FL 33024

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/16/2021
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F50 - Addictive Disorders N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: No
Literary: Yes
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 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 KELLIE DENIS
Signature Title PRESIDENT
Signature Date 9/8/2021

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