FORM 1023-EZ for MIA HENRY

Field Data
EIN 85-1410126
Case Number EO-2020196-000557
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MIA HENRY
Organization’s Mailing Address 1301 E MADISON PARK
City CHICAGO
State IL
ZIP 60615
Accounting period End 12
Primary contact name MIA HENRY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MIA HENRY
PRESIDENT
1301 E MADISON PARK UNIT 1
CHICAGO IL 60615

Officer/Director/Trustee Two

RAMSEY HOMSANY
DIRECTOR
524 VALLEJO
SAN FRANCISCO CA 94133

Officer/Director/Trustee Three

THERESA COLLINS
DIRECTOR
1023 DOBSON
EVANSTON IL 60202

Officer/Director/Trustee Four

FREDA LIN
DIRECTOR
751 36TH AVE
SAN FRANCISCO CA 94121

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/11/2020
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A70 - Humanities Organizations
Organization’s purpose Charitable: No
Religious: No
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 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 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 MIA HENRY
Signature Title PRESIDENT
Signature Date 6/12/2020

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