FORM 1023-EZ for HAELAN HOUSE

Field Data
EIN 84-2698931
Case Number EO-2019331-000333
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HAELAN HOUSE
Organization’s Mailing Address 339 SW CENTURY DRIVE SUITE 203
City BEND
State OR
ZIP 97702
Accounting period End 12
Primary contact name CHERYL MILLS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHERYL MILLS
PRESIDENT
307 E BLACK BUTTE AVENUE
SISTERS OR 97759

Officer/Director/Trustee Two

SUSANNE FRILOT
VICE PRESIDENT
60860 GOSNEY ROAD
BEND OR 97702

Officer/Director/Trustee Three

MARIA COOKSON
SECRETARY/TREASURER
19089 RIVERWOODS DRIVE
BEND OR 97702

Organization’s website HTTPS://WWW.HAELANHOUSE.ORG
Organization’s email HAELANHOUSE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/7/19
Organization Incorporation State OR
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: 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 No
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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 CHERYL MILLS
Signature Title PRESIDENT
Signature Date 11/25/19

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