FORM 1023-EZ for 4TH ANGEL MISSION INC

Field Data
EIN 83-2902929
Case Number EO-2019080-000317
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name 4TH ANGEL MISSION INC
Organization’s Mailing Address 40 SANDBURG COURT
City MIDDLETOWN
State NY
ZIP 10941
Accounting period End 12
Primary contact name VERONIQUE LAROQUE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WILLIAM CEDRIC DJIKE LIEUNAN
PRESIDENT/DIRECTOR
40 SANDBURG COURT
MIDDLETOWN NY 10941

Officer/Director/Trustee Two

VERONIQUE LAROQUE
TREASURER/DIRECTOR
40 SANDBURG COURT
MIDDLETOWN NY 10941

Officer/Director/Trustee Three

KERBIE FRANCOIS
SECRETARY/DIRECTOR
40 SANDBURG COURT
MIDDLETOWN NY 10941

Officer/Director/Trustee Four

ORTHELLO VERGERES
BOARD MEMBER/DIRECTOR
40 SANDBURG COURT
MIDDLETOWN NY 10941

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/30/19
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Q30 - International Development, Relief Services
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 No
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 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 VERONIQUE LAROQUE
Signature Title TREASURER/DIRECTOR
Signature Date 3/19/19

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