FORM 1023-EZ for PERINATAL HEALTH EQUITY FOUNDATION

Field Data
EIN 82-4815853
Case Number EO-2018171-000529
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PERINATAL HEALTH EQUITY FOUNDATION
Organization’s Mailing Address 36 RANDOLPH PLACE
City WEST ORANGE
State NJ
ZIP 7052
Accounting period End 12
Primary contact name NASTASSIA DAVIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAURA JONES
TREASURER
36 RANDOLPH PLACE
WEST ORANGE NJ 7052

Officer/Director/Trustee Three

ALEXIS JERRETT
SECRETARY
36 RANDOLPH PLACE
WEST ORANGE NJ 7052

Officer/Director/Trustee Four

NASTASSIA DAVIS
PRESIDENT
36 RANDOLPH PLACE
WEST ORANGE NJ 7052

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/16/18
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E01 - Alliance/Advocacy Organizations
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 Yes
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 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 NASTASSIA DAVIS
Signature Title PRESIDENT
Signature Date 6/6/18

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