FORM 1023-EZ for AHAVAH COMMUNITY INITIATIVE

Field Data
EIN 83-0667514
Case Number EO-2018205-000113
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name AHAVAH COMMUNITY INITIATIVE
Organization’s Mailing Address 7545 N LOG ROAD
City PEYTON
State CO
ZIP 80831
Accounting period End 12
Primary contact name JOSEPH CAMIRE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSEPH CAMIRE
PRESIDENT, DIRECTOR
7545 N LOG ROAD
PEYTON CO 80831

Officer/Director/Trustee Two

GENA CAMIRE
TREASURER, DIRECTOR
7545 N LOG ROAD
PEYTON CO 80831

Officer/Director/Trustee Three

LYN HARWELL
VICE PRESIDENT, DIRECTOR
2721 W UINTAH STREET
COLORADO SPRINGS CO 80904

Officer/Director/Trustee Four

LONI GARDNER
SECRETARY, DIRECTOR
65 LOWICK DRIVE
COLORADO SPRINGS CO 80906

Officer/Director/Trustee Five

ELLIOT COHN
DIRECTOR
1410 N TEJON STREET
COLORADO SPRINGS CO 80907

Organization’s website
Organization’s email AHAVAHCOMMUNITY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/30/18
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K99 - Food, Agriculture, and Nutrition 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 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 LONI GARDNER
Signature Title SECRETARY, DIRECTOR
Signature Date 7/22/18

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