FORM 1023-EZ for ANDRES HOUSE

Field Data
EIN 82-3594892
Case Number EO-2018136-000466
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ANDRES HOUSE
Organization’s Mailing Address 3 EATON PL
City FARMINGTON
State CT
ZIP 6032
Accounting period End 12
Primary contact name BRUCE SCOTTI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JESURAJ ANTHONYPILLAI
PRESIDENT
3 EATON PL
FARMINGTON CT 6032

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/5/17
Organization Incorporation State CT
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: 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 Yes
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 JESURAJ ANTHONYPILLAI
Signature Title PRESIDENT
Signature Date 5/14/18

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