FORM 1023-EZ for SAFE HAVEN BALLET

Field Data
EIN 83-3359427
Case Number EO-2019038-000359
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SAFE HAVEN BALLET
Organization’s Mailing Address 121 COLONIAL VLG
City SOMERSWORTH
State NH
ZIP 3878
Accounting period End 12
Primary contact name LISSA CURTIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LISSA CURTIS
DIRECTOR
121 COLONIAL VILLAGE
SOMERSWORTHTH NH 3878

Officer/Director/Trustee Two

PHILLIP CURTIS
PRESIDENT
121 COLONIAL VILLAGE
SOMERSWORTH NH 3878

Officer/Director/Trustee Three

DON SILK
TREASURER
31 SUSANNAHS CROSSING
DOVER NH 3820

Officer/Director/Trustee Four

BARBARA SILK
VICE PRESIDENT
31 SUSANNAHS CROSSING
DOVER NH 3820

Officer/Director/Trustee Five

JOANN TOOMEY
SECREARY
3A WITCHOLE RD
EPPING NH 3042

Organization’s website WWW.SAFEHAVENBALLET.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/22/19
Organization Incorporation State NH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A63 - Ballet
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 LISSA CURTIS
Signature Title DIRECTOR
Signature Date 1/30/19

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