FORM 1023-EZ for NATALIES HOUSE

Field Data
EIN 47-4693491
Case Number EO-2016015-000442
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NATALIES HOUSE
Organization’s Mailing Address 1603 WAVERLY AVENUE
City TOLEDO
State OH
ZIP 43607
Accounting period End 12
Primary contact name PASTOR ARTHUR J BATTLE ESQ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DESHAWN JACKSON
PRESIDENT
1603 WAVERLY AVENUE
TOLEDO OH 43607

Officer/Director/Trustee Two

CARL JACKSON
VICE PRESIDENT
1603 WAVERLY AVENUE
TOLEDO OH 43607

Officer/Director/Trustee Three

ALAN COSTNER
TREASURER
1655 GARRETT HOUSE LANE
FAIRFIELD OH 45014

Officer/Director/Trustee Four

DEIDRE WILSON
SECRETARY
1018 ALMIRA AVENUE
CLEVELAND OH 44111

Officer/Director/Trustee Five

ROBIN HESTER
BOARD MEMBER
3935 RUSHLAND AVENUE
TOLEDO OH 43613

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/1/2015
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L41 - Homeless, Temporary Shelter For
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 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 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
Signature Title
Signature Date

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