FORM 1023-EZ for HUMANE HAVEN ANIMAL SANCTUARY CORPORATION

Field Data
EIN 82-4494388
Case Number EO-2018190-000443
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HUMANE HAVEN ANIMAL SANCTUARY CORPORATION
Organization’s Mailing Address 2902 E 6TH ST
City LEHIGH ACRES
State FL
ZIP 33972
Accounting period End 12
Primary contact name DANIELA HABERMEHL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DANIELA HABERMEHL
PRESIDENT
2902 E 6TH ST
LEHIGH ACRES FL 33972

Officer/Director/Trustee Two

LINDSAY NESNIDAL
VICE PRESIDENT
4566 ORANGE RIVER LOOP RD
FORT MYERS FL 33905

Officer/Director/Trustee Three

CHELSEA CHIRILA
DIRECTOR
3122 CHAMPION RING RD
FORT MYERS FL 33905

Officer/Director/Trustee Four

RACHAEL TENZ
DIRECTOR
18210 MAPLE RD
FORT MYERS FL 33967

Officer/Director/Trustee Five

ASHLEY SUNYOG
DIRECTOR
3608 PILOT CIRCLE
NAPLES FL 34120

Organization’s website
Organization’s email DANIELA.HABERMEHL@ICLOUD.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/14/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D20 - Animal Protection and Welfare
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 DANIELA HABERMEHL
Signature Title PRESIDENT
Signature Date 7/5/18

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