FORM 1023-EZ for RAW HAITI INC

Field Data
EIN 46-1573860
Case Number EO-2014225-000372
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name RAW HAITI INC
Organization’s Mailing Address PO BOX 3359
City WESTPORT
State MA
ZIP 02790
Accounting period End 12
Primary contact name EDWARD F ADAMOWSKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

COREY GIFFORD
PRESIDENT
PO BOX 3359
WESTPORT MA 02790

Officer/Director/Trustee Two

EDWARD F ADAMOWSKI
TREASURER
536 HAWTHORN STREET
DARTMOUTH MA 02747

Officer/Director/Trustee Three

NATALIE STURDEVANT
CLERK
522 E 12TH AVE
MITCHELL SD 57301

Officer/Director/Trustee Four

JULIE BROWN
DIRECTOR
1143 MAIN RD
WESTPORT MA 02790

Officer/Director/Trustee Five

MICHAEL KEHOE
DIRECTOR
128 UNION STREET
NEW BEDFORD MA 02740

Organization’s website WWW.RAWHAITI.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/14/2012
Organization Incorporation State MA
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: Yes
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 Yes
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 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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