FORM 1023-EZ for HOUSE OF REFUGE JUVENILE FAMILY SERVICES INC

Field Data
EIN 47-5175308
Case Number EO-2015324-000237
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HOUSE OF REFUGE JUVENILE FAMILY SERVICES INC
Organization’s Mailing Address 6712 MEDIA STREET
City PHILADELPHIA
State PA
ZIP 19151
Accounting period End 12
Primary contact name LAZARUS COLEMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LAZARUS COLEMAN
CHIEF EXECUTIVE OFFICER
6712 MEDIA STREET
PHILADELPHIA PA 19151

Officer/Director/Trustee Two

KIMBERLY JOHNSON
PRESIDENT
3300 HENRY AVENUE SUITE 1
PHILADELPHIA PA 19129

Officer/Director/Trustee Three

JAMES JOSIAH
VICE PRESIDENT
778 BONSALL AVENUE
SHARON HILL PA 19079

Officer/Director/Trustee Four

KAYODE AKINOLA
TREASURER
76 M STREET APT 303
WASHINGTON DC 20001

Officer/Director/Trustee Five

AYO OJO
SECRETARY
6712 MEDIA STREET
PHILADELPHIA PA 19151

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/15/2015
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F32 - Community Mental Health Center
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 Yes
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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