FORM 1023-EZ for HAITIAN AMERICAN NURSES ASSOCIATIONINTERNATIONAL INC

Field Data
EIN 82-4153521
Case Number EO-2018109-000431
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HAITIAN AMERICAN NURSES ASSOCIATIONINTERNATIONAL INC
Organization’s Mailing Address 666 NE 125TH STREET SUITE 238
City NORTH MIAMI
State FL
ZIP 33161-5545
Accounting period End 12
Primary contact name
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARIE ETIENNE
DIRECTOR
666 NE 125TH STREET SUITE 238
NORTH MIAMI FL 33161-5545

Officer/Director/Trustee Two

MARIE HYPPOLITE
DIRECTOR
1122 OCEAN AVENUE
BROOKLYN NY 11230-1975

Officer/Director/Trustee Three

GETTIE AUDAIN
DIRECTOR
666 NE 125TH STREET SUITE 238
NORTH MIAMI FL 33161-5545

Officer/Director/Trustee Four

AMINA DUBUISSON
DIRECTOR
666 NE 125TH STREET SUITE 238
NORTH MIAMI FL 33161-5545

Officer/Director/Trustee Five

YVROSE JEAN
DIRECTOR
889 SUNNY FIELD LANE
LAWRENCEVILLE GA 30043-6710

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/17/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support 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 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 AMINA DUBUISSON
Signature Title DIRECTOR
Signature Date 4/16/18

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