FORM 1023-EZ for LANIAS SAFE HAVEN FOR HOMELESS YOUTH

Field Data
EIN 84-4007022
Case Number EO-2020136-000345
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LANIAS SAFE HAVEN FOR HOMELESS YOUTH
Organization’s Mailing Address 57 OAKVIEW RD
City MATTESON
State IL
ZIP 60443
Accounting period End 12
Primary contact name BLANCHE HAWKINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BLANCHE HAWKINS
PRESIDENT
57 OAKVIEW RD
MATTESON IL

Officer/Director/Trustee Two

CHANNON BROOKS
SECRETARY/TREASURER
7042 S CHAPPEL
CHICAGO IL 60649

Officer/Director/Trustee Three

LAKIMYON WILSON
VICE PRESIDENT
3503 FALLING SPRINGS RD
CAHOKIA IL 62206

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/17/2019
Organization Incorporation State IL
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: 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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name BLANCHE HAWKINS
Signature Title PRESIDENT
Signature Date 5/13/2020

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