FORM 1023-EZ for WORRELS HAVEN

Field Data
EIN 84-4242836
Case Number EO-2020177-000805
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WORRELS HAVEN
Organization’s Mailing Address 730 NORTH BROADWAY
City SHAWNEE
State OK
ZIP 74801
Accounting period End 10
Primary contact name ETHAN FRALEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ETHAN FRALEY
DIRECTOR
4904 N MILITARY AVE
OKLAHOMA CITY OK 73118

Officer/Director/Trustee Two

RACHAEL COLE
OFFICER
10 JARROT DRIVE
SHAWNEE OK 74801

Officer/Director/Trustee Three

TINA LOWRY
DIRECTOR
131 N BELL
SHAWNEE OK 74801

Officer/Director/Trustee Four

TAMMY WALL
DIRECTOR
120 S WEWOKA AVE 2
WEWOKA OK 74884

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/15/2019
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L99 - Housing, Shelter N.E.C.
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 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 ETHAN FRALEY
Signature Title DIRECTOR
Signature Date 6/23/2020

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