FORM 1023-EZ for NEW JERUSALEM EVANGELICAL MISSION INC

Field Data
EIN 81-2086764
Case Number EO-2016123-000066
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NEW JERUSALEM EVANGELICAL MISSION INC
Organization’s Mailing Address 5519 NW 70TH AVE
City TAMARAC
State FL
ZIP 33321
Accounting period End 12
Primary contact name LOUISNEL TERNIVAL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LOUISNEL TERNIVAL
PRESIDENT
6519 NW 70TH AVE
TAMARAC FL 33321

Officer/Director/Trustee Two

ROSE SYDNEY
TREASURER
8513 NW 47TH ST
CORAL SPRINGS FL 33067

Officer/Director/Trustee Three

AUGUSTE JOSEPH
SECRETARY
511 EAST MELROSE CIRCLE
FORT LAUDERDALE FL 33312

Officer/Director/Trustee Four

EMMANUEL RENE
VICE PRESIDENT
6519 NW 70TH AVE
TAMARAC FL 33321

Officer/Director/Trustee Five

WILLIAM ST PHARD
COODINATOR
6519 NW 70TH AVE
TAMARAC FL 33321

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/15/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X99 - Religion Related, Spiritual Development N.E.C.
Organization’s purpose Charitable: No
Religious: Yes
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 Yes
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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