FORM 1023-EZ for AUTHAVEN COMMUNITY

Field Data
EIN 82-5115052
Case Number EO-2018129-000174
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AUTHAVEN COMMUNITY
Organization’s Mailing Address 9020 PINE AVENUE
City BEULAH
State CO
ZIP 81023-9789
Accounting period End 4
Primary contact name JEFFREY BARKS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEFFREY BARKS
PRESIDENT
9020 PINE AVENUE
BEULAH CO 81023-9789

Officer/Director/Trustee Two

DESIREE KAMIKA
TREASURER, DIR EXECUTIVE FUNCTION
2088 WOODPECKER LANE
ELIZABETH CO 80107-8558

Officer/Director/Trustee Three

VICKI GLEITZ
VICE PRESIDENT
9020 PINE AVENUE
BEULAH CO 81023-9789

Officer/Director/Trustee Four

KASSIANE ASASUMASU
PRESIDENT OF PROMOTIONS
4121 SE 28TH AVENUE
PORTLAND OR 97202-3505

Officer/Director/Trustee Five

EMILY TITON
VICE PRESIDENT OF FUND RAISING
57 PEMBERTON AVENUE
JAMESTOWN RI 2835-1489

Organization’s website
Organization’s email AUTHAVENCOMMUNITY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/2/18
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JEFFREY BARKS
Signature Title PRESIDENT
Signature Date 4/29/18

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