FORM 1023-EZ for COMMUNITY MISSIONARY INTERNATIONALINC

Field Data
EIN 81-1077798
Case Number EO-2019105-000630
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COMMUNITY MISSIONARY INTERNATIONALINC
Organization’s Mailing Address 5325 SW 32ND STREET STE 25
City HOLLYWOOD
State FL
ZIP 33023
Accounting period End 12
Primary contact name JEAN-MARIE C FRANCOIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEAN-MARIE C FRANCOIS
DIRECTOR
5325 SW 32ND STREET STE 25
HOLLYWOOD FL 33023

Officer/Director/Trustee Two

PIERRE DESTINE LAURISTON
VICE-PRESIDENT
3400 SW 59 TER
WEST PARK FL 33023

Officer/Director/Trustee Three

MIMOSE METAYER
OFFICER
3811 NW 21 STREET
LAUDERDALE LAKE FL 33311

Officer/Director/Trustee Four

LAMOUSE VALCINA
SECRETARY
5470 COLBRIGHT RD
LAKE WORTH FL 33467

Officer/Director/Trustee Five

MARIE EVELLYNE ELIE JEAN
TREASURER
5325 SW 32 STREET
WEST PARK FL 33023

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/30/15
Organization Incorporation State FL
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: Yes
Educational: Yes
Scientific: Yes
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 JEAN-MARIE C FRANCOIS
Signature Title DIRECTOR
Signature Date 4/13/19
EIN 81-1077798
Case Number EO-2019105-000630
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COMMUNITY MISSIONARY INTERNATIONAL INC
Organization’s Mailing Address 5325 SW 32ND STREET STE 25
City HOLLYWOOD
State FL
ZIP 33023
Accounting period End 12
Primary contact name JEAN-MARIE C FRANCOIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEAN-MARIE C FRANCOIS
DIRECTOR
5325 SW 32ND STREET STE 25
HOLLYWOOD FL 33023

Officer/Director/Trustee Two

PIERRE DESTINE LAURISTON
VICE-PRESIDENT
3400 SW 59 TER
WEST PARK FL 33023

Officer/Director/Trustee Three

MIMOSE METAYER
OFFICER
3811 NW 21 STREET
LAUDERDALE LAKE FL 33311

Officer/Director/Trustee Four

LAMOUSE VALCINA
SECRETARY
5470 COLBRIGHT RD
LAKE WORTH FL 33467

Officer/Director/Trustee Five

MARIE EVELLYNE ELIE JEAN
TREASURER
5325 SW 32 STREET
WEST PARK FL 33023

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/30/15
Organization Incorporation State FL
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: Yes
Educational: Yes
Scientific: Yes
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 JEAN-MARIE C FRANCOIS
Signature Title DIRECTOR
Signature Date 4/13/19

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