FORM 1023-EZ for HEALTH AND EMPOWERMENT FOUNDATION

Field Data
EIN 84-2588660
Case Number EO-2019259-000764
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEALTH AND EMPOWERMENT FOUNDATION
Organization’s Mailing Address 7135 PEARSON RD UNIT 13
City PENSACOLA
State FL
ZIP 32526
Accounting period End 12
Primary contact name WILLIAM KIMA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WILLIAM KIMA
PRESIDENT
7135 PEARSON RD UNIT 13
PENSACOLA FL 32526

Officer/Director/Trustee Two

CLINTON ASABA
VICE PRESIDENT
7135 PEARSON RD UNIT 13
PENSACOLA FL 32526

Officer/Director/Trustee Three

AMINKENG ASONGANYI
SECRETARY
7135 PEARSON RD UNIT 13
PENSACOLA FL 32526

Officer/Director/Trustee Four

YVETTE ENGEMISE
TREASURER
7135 PEARSON RD UNIT 13
PENSACOLA FL 32526

Officer/Director/Trustee Five

JUNIOR NDIFOR
CHAIRPERSON
7135 PEARSON RD UNIT 13
PENSACOLA FL 32526

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/1/19
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
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 WILLIAM KIMA
Signature Title PRESIDENT
Signature Date 9/12/19

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