FORM 1023-EZ for ALPHA HEALTH OUTREACH INC

Field Data
EIN 83-2670277
Case Number EO-2019176-000526
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ALPHA HEALTH OUTREACH INC
Organization’s Mailing Address 9441 SW 20TH STREET
City MIRAMAR
State FL
ZIP 33025
Accounting period End 12
Primary contact name SURETTE SANDS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SURETTE SANDS
PRESIDENT
9441 SW 20TH STREET
MIRAMAR FL 33025

Officer/Director/Trustee Two

CHRISTOPHER SANDS
VICE PRESIDENT
9441 SW 20TH STREET
MIRAMAR FL 33025

Officer/Director/Trustee Three

VERSENA COLEMAN
SECRETARY
616 S HORSESHOE BEND
MAIZE, KS 67101

Officer/Director/Trustee Four

ERNESTINE THURSTON
TREASURER
1531 NW 174 ST
MIAMI, FL 33169

Officer/Director/Trustee Five

IVA ASHE
EXECUTIVE DIRECTOR
1830 NORTH UNIVERSITY DRIVE
PLANTATION FL 33322

Organization’s website
Organization’s email ALPHAHEALTH@BELLSOUTH.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/7/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
Organization’s purpose Charitable: Yes
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 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 SURETTE SANDS
Signature Title PRESIDENT
Signature Date 6/21/19

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