FORM 1023-EZ for SALEM SOBER LIVING MINISTRIES

Field Data
EIN 84-4364272
Case Number EO-2020023-000402
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SALEM SOBER LIVING MINISTRIES
Organization’s Mailing Address 244 S BROADWAY AVE
City SALM
State OH
ZIP 44460-3004
Accounting period End 12
Primary contact name DOUG GEORGE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAUL DOUG GEORGE
PRESIDENT
740 N UNION AVE
SALEM OH 44460-1708

Officer/Director/Trustee Two

DAVID HALVERSTADT II
VICE PRESIDNET
39284 STATE ROUTE 154
LEETONIA OH 44432-8524

Officer/Director/Trustee Three

YVONNER F BENNETT
TREASURER
954 GEORGETOWN RD
SALEM OH 44460-9737

Officer/Director/Trustee Four

FRED B BENNET
SECRETARY
954 GEORGETOWN RD
SALEM OH 44460-9737

Officer/Director/Trustee Five

DAVID A ALLEGO
BOARD MEMBER
1667 SHADY LANE
SALEM OH 44460-1237

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/11/2019
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
Organization’s purpose Charitable: Yes
Religious: Yes
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 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 PAUL DOUG GEORGE
Signature Title PRESIDENT
Signature Date 1/21/2020

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