FORM 1023-EZ for HARAMBEE CARE VILLAGE

Field Data
EIN 82-4705755
Case Number EO-2018141-000514
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HARAMBEE CARE VILLAGE
Organization’s Mailing Address 12811 HEMINGWAY
City REDFORD
State MI
ZIP 48239
Accounting period End 2
Primary contact name ANJANETTE DAVENPORT HATTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHARDAYA FUQUAY
PRESIDENT
66 COLORADO
HIGHLAND PARK MI 48203

Officer/Director/Trustee Two

HOLLY RILEY
SECRETARY
16744 AVON
DETROIT MI 48219

Officer/Director/Trustee Three

CAMIEL DAVENPORT
TREASURER
10054 ROLAN MEADOWS DR
BELLEVILLE MI 48111

Officer/Director/Trustee Four

NICOLE KANERVA-MULLET
MEMBER AT LARGE
31026 MASON
LIVONIA MI 48154

Officer/Director/Trustee Five

ASHA SHAJAHAN
MEMBER AT LARGE
26675 TOWNELY
MADISON HEIGHTS MI 48071

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/8/18
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
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 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 CAMIEL DAVENPORT
Signature Title TREASURER
Signature Date 5/18/18

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