FORM 1023-EZ for MISSION HOSPITAL ESCUELA TGHN

Field Data
EIN 83-4062231
Case Number EO-2019081-000499
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MISSION HOSPITAL ESCUELA TGHN
Organization’s Mailing Address 7359 TREE RIDGE CT
City FORT WORTH
State TX
ZIP 76133
Accounting period End 2
Primary contact name XIOMARA OCASIO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSE OCASIO
DIRECTOR
7359 TREE RIDGE CT
FORT WORTH TX 76133-6566

Officer/Director/Trustee Two

JOHANIS DE LA FUENTE
DIRECTOR
5240 POST RIDGE DR
FORT WORTH TX 76123

Officer/Director/Trustee Three

JENNING BYRON KELLY
DIRECTOR
132 W MILLER ST
BURLESON TX 76028

Officer/Director/Trustee Four

XIOMARA OCASIO
DIRECTOR
7359 TREE RIDGE CT
FORT WORTH TX 76133-6566

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/7/19
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds No
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name XIOMARA OCASIO
Signature Title DIRECTOR
Signature Date 3/20/19

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