FORM 1023-EZ for CITY OF HOPE SAFE HAVEN

Field Data
EIN 47-4566391
Case Number EO-2015205-000414
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CITY OF HOPE SAFE HAVEN
Organization’s Mailing Address 5389 WINDING GLEN DR
City LITHONIA
State GA
ZIP 30038-2398
Accounting period End 12
Primary contact name ALECIA WASHINGTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ALECIA WASHINGTON
DIRECTOR
5389 WINDING GLEN DR
LITHONIA GA 30038-2398

Officer/Director/Trustee Two

SHAPPHIRA MCINTOSH
DIRECTOR
2638 PARKWAY TRAIL
LITHONIA GA 30058-4651

Officer/Director/Trustee Three

TAMMY ROBBINS
DIRECTOR
6159 IDLEWOOD PASS
LITHONIA GA 30038-6272

Officer/Director/Trustee Four

JUVAN WASHINGTON
DIRECTOR
5778 REX MILL TERR
REX GA 30273-1395

Officer/Director/Trustee Five

ROBIN MAY
DIRECTOR
7593 POPLAR FALLS STREET
LITHONIA GA 30058-1550

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/26/2015
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P85 - Homeless Persons Centers, Services
Organization’s purpose Charitable: Yes
Religious: Yes
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 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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