FORM 1023-EZ for THE PAX HOUSE

Field Data
EIN 47-3152895
Case Number EO-2016047-000094
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE PAX HOUSE
Organization’s Mailing Address 2142 RAVINE STREET
City CINCINNATI
State OH
ZIP 45214
Accounting period End 12
Primary contact name DANA MCMAHAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DANA MCMAHAN
CEO
7326 WOODCROFT DRIVE
ANDERSON TOWNSHIP OH 45230

Officer/Director/Trustee Two

EVE KOEHNEN
TREASURER
7000 ST RT 8
SPRINGBORO OH 45066

Officer/Director/Trustee Three

JERRY STINEMAN
ATTORNEY
7843 LAUREL AVENUE
CINCINNATI OH 45243

Officer/Director/Trustee Four

TIFFANY GINGRICH
FUNDRAISING
3293 MONTANA AVE
CINCINNATI OH 45211

Officer/Director/Trustee Five

LINDA MCPHERSON
BOARD MEMBER
529 WEDGE WAY
MASON OH 45040

Organization’s website THEPAXHOUSE.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/2015
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P72 - Half-Way House (Short-Term Residential Care)
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
Signature Title
Signature Date

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