FORM 1023-EZ for MY SISTERS PLACE HT INC

Field Data
EIN 47-5419577
Case Number EO-2017026-000089
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MY SISTERS PLACE HT INC
Organization’s Mailing Address 3405 HALLMARK DRIVE SE
City MARIETTA
State GA
ZIP 30067-5112
Accounting period End 10
Primary contact name BERNARD L PEAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MIA FRANCINE PEAN
DIRECTOR AND PRESIDENT/CEO
1786 BYROM PKWY
JONESBORO GA 30236-7446

Officer/Director/Trustee Two

HARSON CRAAN JULIEN
TREASURER/CFO
1786 BYROM PKWY
JONESBORO GA 30236-7446

Officer/Director/Trustee Three

LAURA DOMINIQUE BOUZI
SECRETARY
2 WALKER TERRACE
CAMBRIDGE MA 02138-2416

Officer/Director/Trustee Four

BERNARD LEONARD PEAN
VICE PRESIDENT
3405 HALLMARK DRIVE SE
MARIETTA GA 30067-5112

Officer/Director/Trustee Five

ANDRE APAID JR
DIRECTOR
7209 N W 41 STREET
MIAMI FL 33166-6711

Organization’s website WWW.MYSISTERSPLACEHAITI.ORG
Organization’s email MYSISTERKEEPERHT@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/15/2016
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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
Signature Title
Signature Date

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