FORM 1023-EZ for FAYETTE COUNTY SAFE HAVEN
| Field | Data |
|---|---|
| EIN | 81-4053200 |
| Case Number | EO-2016356-000098 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | FAYETTE COUNTY SAFE HAVEN |
| Organization’s Mailing Address | 1110 STORYBROOK DRIVE |
| City | WASHINGTON COURTHOUS |
| State | OH |
| ZIP | 43160 |
| Accounting period End | 12 |
| Primary contact name | PAMELA COBURN |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
PAMELA COBURN
EXECUTIVE DIRECTOR
1110 STORYBROOK DRIVE
WASHINGTON COURTHOUS OH 43160
Officer/Director/Trustee Two
MARY STEWART
SECRETARY/TREASURER
RAWLINGS ST
WASHINGTON COURTHOUS OH 43160
Officer/Director/Trustee Three
SHONA BAISDIN
CHAIRPERSON
1110 STORYBROOK DRIVE
WASHINGTON COURTHOUS OH 43160
Officer/Director/Trustee Four
GAYE HUFFMAN
BOARD
320 HINDE ST
WASHINGTON COURTHOUS OH 43160
Officer/Director/Trustee Five
MOLLY GRUBER
BOARD
CENTRE ST
WASHINGTON COURTHOSU OH 43160
| Organization’s website | |
|---|---|
| Organization’s email | FAYETTECOUNTYSAFEHAVEN@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/26/2016 |
| Organization Incorporation State | OH |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P85 - Homeless Persons Centers, Services |
| Organization’s purpose | Charitable: Yes Religious: No Educational: No Scientific: No Literary: No Public Safety: No Amateur Sports: No Cruelty Prevention: Yes |
| 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 | Yes |
| 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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