FORM 1023-EZ for SAFE AND HEALTHY COMMUNITIES

Field Data
EIN 47-3304540
Case Number EO-2016111-000277
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SAFE AND HEALTHY COMMUNITIES
Organization’s Mailing Address 5774 SOUTH KLINE STREET
City LITTLETON
State CO
ZIP 80127
Accounting period End 12
Primary contact name KAREN ROOF
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KAREN ROOF
DIRECTOR
5774 SOUTH KLINE STREET
LITTLETON CO 80127

Officer/Director/Trustee Two

MARK OBRIEN
CHAIR
7395 EAST EASTMAN AVE
DENVER CO 80231

Officer/Director/Trustee Three

SHELLEY TERAS
TREASURER
15537 EAGLE TAVERN LANE
CENTREVILLE VA 20120

Officer/Director/Trustee Four

SUSIE GUNN
SECRETARY
2525 ARAPAHOE AVE
BOULDER CO 80302

Officer/Director/Trustee Five

MARLA HOLLANDER
VICE-CHAIR
4100 WARNER STREET
KENSINGTON MD 20895

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/1/2015
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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 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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