FORM 1023-EZ for HAVEN VESICOVAGINAL FISTULA FOUNDATION
| Field | Data |
|---|---|
| EIN | 82-4507845 |
| Case Number | EO-2018108-000053 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | HAVEN VESICOVAGINAL FISTULA FOUNDATION |
| Organization’s Mailing Address | 3545 BROAD ST 660171 |
| City | CHAMBLEE |
| State | GA |
| ZIP | 30366 |
| Accounting period End | 12 |
| Primary contact name | FATIMA ABUBAKAR OR EKENE OMOZEGIE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
FATIMA ABUBAKAR
FOUNDER AND CEO
3155 FLOWERS ROAD SOUTH
ATLANTA GA 30341
Officer/Director/Trustee Two
EKENE OMOZEGIE
CHIEF FINANCIAL OFFICER
3170 THORNGATE COURT
SNELLVILLE GA 30078
Officer/Director/Trustee Three
TITI EBELEDIKE
CHIEF OFFICER FOR MEDICAL RELATIONS
10420 CIRCLE DR APT 32B
OAK LAWN IL 60453
Officer/Director/Trustee Four
AMINA WALI SHAFEEQ
CHIEF STRATEGIC OPERATIONS OFFICE
3158 LANCER DR
POWDER SRING GA 30127
| Organization’s website | WWW.HVVFF.ORG |
|---|---|
| Organization’s email | HVVFF.ORG@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 3/1/18 |
| Organization Incorporation State | GA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E12 - Fund Raising and/or Fund Distribution |
| 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 | 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 | FATIMA ABUBAKAR |
| Signature Title | FOUNDER AND CEO |
| Signature Date | 3/20/18 |
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