FORM 1023-EZ for ST FRANCIS HOME HEALTH CARE INC

Field Data
EIN 83-1461240
Case Number EO-2018267-000224
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ST FRANCIS HOME HEALTH CARE INC
Organization’s Mailing Address 2345 HAMILTON RD
City OKEMOS
State MI
ZIP 48864-1611
Accounting period End 12
Primary contact name DAVID ROSENBERG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID ROSENBERG
DIRECTOR
2345 HAMILTON RD
OKEMOS MI 48864-1611

Officer/Director/Trustee Two

MICHAEL KUTAS
SECRETARY
703 E MAIN ST
DEWITT MI 49920

Officer/Director/Trustee Three

ROBERTA SCHOMBERGER
CO-DIRECTOR
6090 MUNSELL
HOWELL MI 48843

Officer/Director/Trustee Four

SEAN ROSENBERG
CO-DIRECTOR
205 W RIVERSIDE DR
JUPITER FL 33469

Officer/Director/Trustee Five

SARA ROSENBERG
CO-DIRECTOR
205 W RIVERSIDE DR
JUPITER FL 33469

Organization’s website HTTP://STFRANCIS.WS
Organization’s email DROSENBERG@STFRANCISHHC.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/6/18
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E92 - Home Health Care
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 Yes
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 DAVID ROSENBERG
Signature Title DIRECTOR
Signature Date 9/20/18

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