FORM 1023-EZ for A PLACE FOR JACOB

Field Data
EIN 82-5287656
Case Number EO-2018190-000528
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name A PLACE FOR JACOB
Organization’s Mailing Address 2461 FURNACE RD
City FELTON
State PA
ZIP 17322
Accounting period End 12
Primary contact name LAURIE L HOWARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAURIE HOWARD
DIRECTOR
2461 FURNACE RD
FELTON PA 17322

Officer/Director/Trustee Two

MARK HOWARD
CO- DIRECTOR
2461 FURNACE RD
FELTON PA 17322

Officer/Director/Trustee Three

HEATHER MILLER
ACCOUNTANT
57 S THIRD STREET
MY WOLF PA 17347

Organization’s website WWW.APLACEFORJACOB.WEBS.COM
Organization’s email APLACEFORJACOB@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/16
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P73 - Group Home (Long Term)
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name LAURIE HOWARD
Signature Title DIRECTOR
Signature Date 7/7/18

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