FORM 1023-EZ for HEALTHY HOUSE

Field Data
EIN 47-4050554
Case Number EO-2015142-000500
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEALTHY HOUSE
Organization’s Mailing Address 1835 NICHOLS RD
City KALAMAZOO
State MI
ZIP 40006
Accounting period End 12
Primary contact name PATRICK COFFEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PATRICK COFFEY
PRESIDENT
1835 NICHOLS RD
KALAMAZOO MI 40006

Officer/Director/Trustee Two

PAMELA COFFEY
TREASURER
1835 NICHOLS RD
KALAMAZOO MI 40006

Officer/Director/Trustee Three

YOLANDA HARRIS
SECRETARY
1835 NICHOLS RD
KALAMAZOO MI 40006

Officer/Director/Trustee Four

MARK GOYER
MEMBER
192 WEST CROOKED LAKE DR
PORTAGE MI 49002

Officer/Director/Trustee Five

BARBARA ADAMS
MEMBER
1300 CONCORD PLACE 2C
KALAMAZOO MI 49009

Organization’s website
Organization’s email HEAVENNOW@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/6/2015
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 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 Yes
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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