FORM 1023-EZ for LACEYS HOUSE

Field Data
EIN 75-3053772
Case Number EO-2021250-000577
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LACEYS HOUSE
Organization’s Mailing Address 409 EASTON ROAD P1
City WILLOW GROVE
State PA
ZIP 19090
Accounting period End 12
Primary contact name TRACIE OTIENO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TRACIE OTIENO
PRESIDENT
409 EASTON ROAD P1
WILLOW GROVE PA 19090

Officer/Director/Trustee Two

LACEY HENRY-MCCRAY
SECRETARY
409 EASTON ROAD P1
WILLOW GROVE PA 19090

Officer/Director/Trustee Three

GODFREY OTIENO
TREASURER & DIRECTOR
409 EASTON ROAD P1
WILLOW GROVE PA 19090

Organization’s website
Organization’s email TRACIEHENRY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/2/2020
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F01 - Alliance/Advocacy Organizations
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 Yes
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 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 TRACIE OTIENO
Signature Title PRESIDENT
Signature Date 9/3/2021

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