FORM 1023-EZ for SUPPORT H2O INC

Field Data
EIN 47-1621184
Case Number EO-2015140-000228
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SUPPORT H2O INC
Organization’s Mailing Address 2601 PADDOCK GATE COURT
City HERNDON
State VA
ZIP 20171
Accounting period End 12
Primary contact name JACOB VARGIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JACOB VARGIS
DIRECTOR AND PRESIDENT
2601 PADDOCK GATE COURT
HERNDON VA 20171

Officer/Director/Trustee Two

THOMAS JACOB
DIRECTOR AND SECRETARY
2516 LOCUSTWOOD PL
SILVER SPRING MD 20905

Officer/Director/Trustee Three

JOLLY JOHNSON
DIRECTOR
2601 PADDOCK GATE COURT
HERNDON VA 20171

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/6/2014
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 Yes
Donation of funds No
Conducting Activities Outside of United States Yes
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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