FORM 1023-EZ for KAREN HUMAN SERVICES OF AMERICA

Field Data
EIN 47-2548896
Case Number EO-2015131-000219
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KAREN HUMAN SERVICES OF AMERICA
Organization’s Mailing Address 1280 WESTMINSTER STREET SUITE 304
City SAINT PAUL
State MN
ZIP 55130
Accounting period End 4
Primary contact name AHMAY YA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

AHMAY YA
CO FOUNDER CEO ( EXECUTIVE DIRECT
1280 WESTMINSTER STREET APT 304
SAINT PAUL MN 55130

Officer/Director/Trustee Two

YOHA CHRISTIANSON
VICE PRESIDENT
184 MT AIRY STREET
SAINT PAUL MN 55130

Officer/Director/Trustee Three

KYAW KHAING
TREASURER/SECRETARY
1280 WESTMINSTER STREET APT 304
SAINT PAUL MN 55130

Officer/Director/Trustee Four

KLAY SU
SECRETARY
1336 MISSISSIPPI STREET APT 201
SAINT PAUL MN 55130

Officer/Director/Trustee Five

PHA THIN
ASSISTANT SECRETARY
1070 MISSISSIPPI STREET APT 201
SAINT PAUL MN 55130

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/26/2014
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A70 - Humanities Organizations
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 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
Signature Title
Signature Date

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