FORM 1023-EZ for UROLOGY VOLUNTEERS IN HAITI INC
| Field | Data |
|---|---|
| EIN | 84-2699154 |
| Case Number | EO-2019231-000583 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | UROLOGY VOLUNTEERS IN HAITI INC |
| Organization’s Mailing Address | 3168 NW 63RD ST |
| City | BOCA RATON |
| State | FL |
| ZIP | 33496 |
| Accounting period End | 12 |
| Primary contact name | HILARY ROSE EA |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
JEFFREY MILLER
DIRECTOR
3168 NW 63RD ST
BOCA RATON FL 33496
Officer/Director/Trustee Two
ALAN STEIN
DIRECTOR
10A RIO VISTA
LADUE MO 63124
Officer/Director/Trustee Three
DANIEL CONDER HAAR
DIRECTOR
1122 GREYSTONE MANOR PKWY
CHESTERFIELD MO 63005
Officer/Director/Trustee Four
ROBERT GRUBB III
DIRECTOR
187 WENTWORTH ST
CHARLESTOWN SC 29401
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 2/14/19 |
| Organization Incorporation State | FL |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | G9B - Surgery |
| 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 | No |
| Donation of funds | No |
| 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 | Yes |
| One Third Support Gifts | No |
| Benefit of College | No |
| Private Foundation 508(e) | No |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | JEFFREY MILLER |
| Signature Title | DIRECTOR |
| Signature Date | 8/17/19 |
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