FORM 1023-EZ for HS HAITI FOUNDATION

Field Data
EIN 85-1834610
Case Number EO-2020318-000084
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HS HAITI FOUNDATION
Organization’s Mailing Address 625 AIRPORT RD SW
City HUNTSVILLE
State AL
ZIP 35802
Accounting period End 6
Primary contact name JULIE GROARK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JULIE GROARK
PRESIDENT
2726 MUIR WOODS DR
OWENS CROSS RDS AL 35763

Officer/Director/Trustee Two

TIM STEIGERWALD
TREASURER
3032 AUGUSTA TRACE
OWENS CROSS RDS AL 35763

Officer/Director/Trustee Three

LAUREN BRYANT
VICE PRESIDENT
1226 WILLOWBROOK DR
HUNTSVILLE AL 35802

Officer/Director/Trustee Four

NICHOLAS PRICE
SECRETARY
213 EVALYN ST
MADISON AL 35758

Officer/Director/Trustee Five

MICHAEL MACMAHON
TRUSTEE
625 AIRPORT RD
HUNTSVILLE AL 35802

Organization’s website
Organization’s email jcgroark@icloud.com
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/1/2020
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: No
Religious: Yes
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 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 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 JULIE GROARK
Signature Title PRESIDENT
Signature Date 11/11/2020

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