FORM 1023-EZ for HABILITATION SERVICES

Field Data
EIN 81-3541400
Case Number EO-2016364-000184
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HABILITATION SERVICES
Organization’s Mailing Address 212 RIVERVIEW DRIVE NE
City AUBURN
State WA
ZIP 98002
Accounting period End 12
Primary contact name JULIE HERREN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JULIE HERREN
CEO/DIRECTOR
212 RIVERVIEW DRIVE NE
AUBURN WA 98002-5102

Officer/Director/Trustee Two

EVELYN ECHEVERRIA
CFO/TREASURER
225 N ST SE
AUBURN WA 98002

Officer/Director/Trustee Three

RUTH HERREN
CHAIRPERSON OF GOVERNING BODY
525 R STREET NE
AUBURN WA 98002

Officer/Director/Trustee Four

DENNIS KIP HERREN
SECRETARY
212 RIVERVIEW DRIVE NE
AUBURN WA 98002

Officer/Director/Trustee Five

JOSEPH RUSH
VICE PRESIDENT
525 R STREET NE
AUBURN WA 98002

Organization’s website N/A
Organization’s email HABILITATIONSERVICES@OUTLOOK.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/12/2016
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P82 - Developmentally Disabled Centers, Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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