FORM 1023-EZ for HAITIAN AMERICAN NURSES ASSOCIATIONOF TAMPA INC

Field Data
EIN 46-5527947
Case Number EO-2017009-000457
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HAITIAN AMERICAN NURSES ASSOCIATIONOF TAMPA INC
Organization’s Mailing Address 10115 NORTH BROOKS ST
City TAMPA
State FL
ZIP 33612
Accounting period End 12
Primary contact name SALMA BENKABBOU
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHAKEMA DOREUS
PRESIDENT
10115 NORTH BROOKS ST
TAMPA FL 33612

Officer/Director/Trustee Two

EDLINE PIERRE
VICE PRESIDENT
2421 ROANOKE SPRINGS DR
RUSKIN FL 33570

Officer/Director/Trustee Three

NARAH PLANCHER
SECRETARY
2846 SOMERSET PARK DRIVE APT 202
TAMPA FL 33613

Officer/Director/Trustee Four

GABRIELA BAROLETTE
TREASURER
7220 FAULKNER LN APT 208
TRINITY FL 34655

Officer/Director/Trustee Five

QUINNA DORLEUS
ASSISTANT SECRETARY
15105 BUCKHORN COURT APT 201C
TAMPA FL 33559

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/11/2014
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B03 - Professional Societies, Associations
Organization’s purpose Charitable: No
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 Yes
Donation of funds Yes
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 No
One Third Support Gifts Yes
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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