FORM 1023-EZ for HEALTHCARE INNOVATION INSTITUTE

Field Data
EIN 82-1841636
Case Number EO-2018032-000232
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEALTHCARE INNOVATION INSTITUTE
Organization’s Mailing Address 100 SADDLE HILL RD
City DE LAND
State FL
ZIP 32720
Accounting period End 12
Primary contact name MARCUS KNUDSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARCUS KNUDSON
CEO
705 SE PLEASANT VIEW DR
WAUKEE IA 50263

Officer/Director/Trustee Two

BARBARA DUFFY
COO
100 SADDLE HILL RD
DE LAND FL 32720

Organization’s website HIINSTITUTE.ORG
Organization’s email MKNUDSON@HIINSTITUTE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/2/17
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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 MARCUS KNUDSON
Signature Title CEO
Signature Date 1/30/18

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