FORM 1023-EZ for HOOSIER HABITAT REHABILITATION

Field Data
EIN 81-1973972
Case Number EO-2016097-000209
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HOOSIER HABITAT REHABILITATION
Organization’s Mailing Address 1092 N STATE ROAD 267
City AVON
State IN
ZIP 46123
Accounting period End 9
Primary contact name ERIC HARVEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ERIC HARVEY
FOUNDER/ OFFICER
1092 N STATE ROAD 267
AVON IN 46123

Officer/Director/Trustee Two

ROBERT MCFARLING
VISIONARY
4226 KESSLER BLVD N
INDIANAPOLIS IN 46228

Officer/Director/Trustee Three

PAMELA ALTMEYER ALVEY
MEMBER
3556 HIGHWOODS DRIVE NORTH
INDIANAPOLIS IN 46222

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/28/2016
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
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 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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