FORM 1023-EZ for DOUGLAS HOUSE TRANSITIONAL LIVING PROGRAM
| Field | Data |
|---|---|
| EIN | 84-3534657 |
| Case Number | EO-2019357-000562 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | DOUGLAS HOUSE TRANSITIONAL LIVING PROGRAM |
| Organization’s Mailing Address | 231 EAST WASHINGTON ST |
| City | CHAMBERSBURG |
| State | PA |
| ZIP | 17201 |
| Accounting period End | 12 |
| Primary contact name | MICHAEL DOUGLAS |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
MICHAEL DOUGLAS SR
DIRECTOR
231 EAST WASHINGTON ST
CHAMBERSBURG PA 17201
Officer/Director/Trustee Two
STEPHANIE BIRMINGHAM
DIRECTOR
231 EAST WASHINGTON ST
CHAMBERSBURG PA 17201
Officer/Director/Trustee Three
MAHOGANY GANT
DIRECTOR
231 EAST WASHINGTON ST
CHAMBERSBURG PA 17201
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/31/2019 |
| Organization Incorporation State | PA |
| 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: Yes Scientific: Yes 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 | Yes |
| Conducting Activities Outside of United States | No |
| Financial transactions with officers | No |
| Unrelated Gross Income $1,000 or More | Yes |
| Gaming Activity | No |
| Disaster relief assistance | Yes |
| 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 | MICHAEL DOUGLAS SR |
| Signature Title | DIRECTOR |
| Signature Date | 12/21/2019 |
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