FORM 1023-EZ for OHANA SAFE HAVEN INC

Field Data
EIN 81-2453127
Case Number EO-2019031-000585
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name OHANA SAFE HAVEN INC
Organization’s Mailing Address 10 WOOD ST
City WAYNE
State NJ
ZIP 7470
Accounting period End 12
Primary contact name LATOYHA SAPP
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CLEOPHUS SHOULARS
TREASURER
324 EAST 29TH ST
PATERSON NJ 7514

Officer/Director/Trustee Two

SAMANTHA GREENE
SECRETARY
14 LEE AVE
HALEDON NJ 7508

Officer/Director/Trustee Three

KATHLEEN JONES
PRESIDENT
10 WOOD ST
WAYNE NJ 7514

Officer/Director/Trustee Four

LATOYHA SAPP
FOUNDER
10 WOOD ST
WAYNE NJ 7470

Organization’s website
Organization’s email OHANASAFEHAVEN@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/5/17
Organization Incorporation State NJ
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 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 LATOYHA SAPP
Signature Title FOUNDER
Signature Date 1/4/19

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