FORM 1023-EZ for HER WORTH INTERNATIONAL INC

Field Data
EIN 47-5670101
Case Number EO-2016104-000046
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HER WORTH INTERNATIONAL INC
Organization’s Mailing Address 12568 NW GROVESHIRE AVE
City BANKS
State OR
ZIP 97106
Accounting period End 12
Primary contact name RACHEL ROSE NELSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RACHEL NELSON
PRESIDENT CEO
12568 NW GROVESHIRE AVE
BANKS OR 97106

Officer/Director/Trustee Two

JEAN NEVILLS
SECRETARY/TREASURER
33660 SW LARKINS MILL ROAD
HILLSBORO OR 97123

Officer/Director/Trustee Three

CHERYL MATSCHECK
CHAIRPERSON
39767 NW MUTAUGH RD
NORTH PLAINS OR 97133

Organization’s website HTTP://WWW.HERWORTH.COM
Organization’s email RACHEL@HERWORTH.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/24/2015
Organization Incorporation State OR
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: 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 Yes
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
Signature Title
Signature Date

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