FORM 1023-EZ for JADI HABITIIN ENTERPRISE

Field Data
EIN 81-2567752
Case Number EO-2017230-000257
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JADI HABITIIN ENTERPRISE
Organization’s Mailing Address PO BOX 2887
City PAGE
State AZ
ZIP 86040
Accounting period End 12
Primary contact name CHRISTINA TALLEY CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAISY YAZZIE
PRESIDENT
PO BOX 6145
MARBLE CANYON AZ 86036

Officer/Director/Trustee Two

LEONARD SLOAN
VICE PRESIDENT
PO BOX 1435
GAP AZ 86020

Officer/Director/Trustee Three

EVA TSOSIE
SECRETARY
PO BOX 1426
GAP AZ 86020

Officer/Director/Trustee Four

DARRELL ACOTHLEY
TREASURER
PO BOX 2734
TUBA CITY AZ 86045

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/26/2016
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S30 - Economic Development
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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