FORM 1023-EZ for HABITAT FOR HARRY

Field Data
EIN 82-1650140
Case Number EO-2017240-000205
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HABITAT FOR HARRY
Organization’s Mailing Address 307 CHARLOTTE AVENUE
City CAROLINA BEACH
State NC
ZIP 28428
Accounting period End 12
Primary contact name DEBEA LECOMPTE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRYANT BASS
PRESIDENT
117 LEEWARD COURT
KURE BEACH NC 28449

Officer/Director/Trustee Two

KEITH BLOEMENDAAL
VICE PRESIDENT
305 PENINSULA DRIVE
CAROLINA BEACH NC 24828

Officer/Director/Trustee Three

TERESA SHUE
SECRETARY
510 E 3RD STREET
CAROLINA BEACH NC 28482

Officer/Director/Trustee Four

DEBRA LECOMPTE
TREASURER
307 CHARLOTTE AVENUE
CAROLINA BEACH NC 28428

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/27/2017
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, 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 Yes
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 Yes
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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