FORM 1023-EZ for STATEN HOUSE INC

Field Data
EIN 85-4138639
Case Number EO-2021099-001918
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name STATEN HOUSE INC
Organization’s Mailing Address 11334 BREMERTON CIRCLE
City INDIANAPOLIS
State IN
ZIP 46229
Accounting period End 9
Primary contact name SHERI STATEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHERI STATEN
PRESIDENT, CEO & DIRECTOR
11334 BREMERTON CIRCLE
INDIANAPOLIS IN 46229

Officer/Director/Trustee Two

JEREMIAH BONNER
TREASURER
290 S UNION ST
BLOOMINGTON IN 47406

Officer/Director/Trustee Three

CHERRY STATEN
SECRETARY & DIRECTOR
6720 PARKDALE PLACE
INDIANAPOLIS IN 46226

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/3/2020
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F33 - Group Home, Residential Treatment Facility - Mental Health Related
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 No
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
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 SHERI STATEN
Signature Title PRESIDENT, CEO & DIRECTOR
Signature Date 3/29/2021

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