FORM 1023-EZ for FARM HAITI

Field Data
EIN 84-3783468
Case Number EO-2019338-000189
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FARM HAITI
Organization’s Mailing Address 11316 178TH ST W
City LAKEVILLE
State MN
ZIP 55044
Accounting period End 12
Primary contact name MARY HARRIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RODNEY HARRIS
PRESIDENT
11316 178 ST W
LAKEVILLE MN 55044

Officer/Director/Trustee Two

MARY HARRIS
VICE PRESIDENT AND TREASURER
11316 178TH ST W
LAKEVILLE MN 55044

Officer/Director/Trustee Three

ANITA MACKAY
SECRETARY
12626 FAIRBANKS AVE
LONSDALE MN 55046

Officer/Director/Trustee Four

CLIFFORD HANSON
DIRECTOR
17942 69TH PL N
MAPLE GROVE MN 55311

Officer/Director/Trustee Five

RICHARD FELCH
DIRECTOR
3531 WILLOW BEACH TRAIL
PRIOR LAKE MN 55372

Organization’s website NA
Organization’s email MARYANDER14@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/24/19
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States Yes
Financial transactions with officers Yes
Unrelated Gross Income $1,000 or More No
Gaming Activity Yes
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 MARY HARRIS
Signature Title VICE PRESIDENT TREASURER
Signature Date 12/2/19

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