FORM 1023-EZ for HASANNA HOUSE MINISTRIES

Field Data
EIN 45-5245285
Case Number EO-2015364-000094
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HASANNA HOUSE MINISTRIES
Organization’s Mailing Address 2275 BAUTISTA AVE
City VISTA
State CA
ZIP 92084
Accounting period End 12
Primary contact name GEOFFREY SELF
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GEOFFREY SELF
PRESIDENT
2275 BAUTISTA AVE
VISTA CA 92084

Officer/Director/Trustee Two

MIKE WLUCZEWSKI
VICE PRESIDENT
2474 GUAJOME LAKE ROAD
VISTA CA 92084

Officer/Director/Trustee Three

KARYN WLOCZEWSKI
SECRETARY
2474 GOAJOME LAKE ROAD
VISTA CA 92084

Officer/Director/Trustee Four

DAWN MERRILL
TREASURER
2275 BAUTISTA AVE
VISTA CA 92084

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/20/2012
Organization Incorporation State CA
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
Signature Title
Signature Date

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