FORM 1023-EZ for SAFE HAVEN ES INC

Field Data
EIN 83-1630818
Case Number EO-2019130-000147
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SAFE HAVEN ES INC
Organization’s Mailing Address 352 BAY AVE
City PATCHOGUE
State NY
ZIP 11772
Accounting period End 12
Primary contact name KEVIN BURKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROY DONATO
PRESIDENT, DIRECTOR
352 BAY AVENUE
PATCHOGUE NY 11772

Officer/Director/Trustee Two

PETER ANGELORA
DIRECTOR
9 LEO STREET
PATCHOGUE NY 11772

Officer/Director/Trustee Three

KEVIN BURKE
TREASURER, DIRECTOR
63 BLUEBERRY RIDGE DRIVE
HOLTSVILLE NY 11742

Officer/Director/Trustee Four

JEROME MORELLO
SECRETARY, DIRECTOR
121 AVERY AVENUE
PATCHOGUE NY 11772

Officer/Director/Trustee Five

CARMINE GRUCCI
DIRECTOR
59 CARMEN STREET
PATCHOGUE NY 11772

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/9/18
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L40 - Low-Cost Temporary Housing
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 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 ROY DONATO
Signature Title PRESIDENT, DIRECTOR
Signature Date 5/8/19

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