FORM 1023-EZ for HAVENS RESCUE OF WASHINGTON NC

Field Data
EIN 47-5500064
Case Number EO-2015310-000419
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HAVENS RESCUE OF WASHINGTON NC
Organization’s Mailing Address 7487 HWY 264 EAST
City WASHINGTON
State NC
ZIP 27889-4251
Accounting period End 12
Primary contact name CALLIE CAROL JONES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CALLIE CAROL JONES
CEO
849 HACKNEY AVE
WASHINGTON NC 27889-4251

Officer/Director/Trustee Two

JACK HERMAN JONES
CHAIRPERSON
849 HACKNEY AVE
WASHINGTON NC 27889-4251

Officer/Director/Trustee Three

NATHAN BROWN
TREASURER
573 S SQUARE DR APT 107
WINTERVILLE NC 28590-8596

Organization’s website
Organization’s email HAVENSRESCUE8@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/4/2015
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family Services
Organization’s purpose Charitable: Yes
Religious: Yes
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 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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