FORM 1023-EZ for LEVIS HOUSE

Field Data
EIN 46-1859522
Case Number EO-2014303-000531
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LEVIS HOUSE
Organization’s Mailing Address 16 N UNION BLVD
City COLORADO SPRINGS
State CO
ZIP 80909
Accounting period End 12
Primary contact name JOHN ALBAUGH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JOHN ALBAUGH
PRESIDENT
16 N UNION BLVD
COLORADO SPRINGS CO 80909

Officer/Director/Trustee Two

GARY SKINNER
DIRECTOR
16 N UNION BLVD
COLORADO SPRINGS CO 80909

Officer/Director/Trustee Three

DAN LEYES
TREASURER
228 E ESPANOLA ST
COLORADO SPRINGS CO 80907

Organization’s website LEVISHOUSE.ORG
Organization’s email JOHN@LEVISHOUSE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/29/2013
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I40 - Rehabilitation Services for Offenders
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 No
Unrelated Gross Income $1,000 or More No
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
Signature Title
Signature Date

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