FORM 1023-EZ for HAITIAN ABUNDANT LIFE MISSION INC

Field Data
EIN 83-3680856
Case Number EO-2019092-000507
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HAITIAN ABUNDANT LIFE MISSION INC
Organization’s Mailing Address 4388 DELTA STREET SUITE 3
City SAN DIEGO
State CA
ZIP 92113
Accounting period End 12
Primary contact name NORMAN POWELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

OSSE MENARD
PRESIDENT
4388 DELTA ST SUITE 3
SAN DIEGO CA 92113

Officer/Director/Trustee Two

PERRETTE MENARD
VICE PRESIDENT
4388 DELTA ST SUITE 3
SAN DIEGO CA 92113

Officer/Director/Trustee Three

RICHARD SIMON
SECRETARY
4388 DELTA ST SUITE 3
SAN DIEGO CA 92113

Officer/Director/Trustee Four

LINA LACOMBE
VICE SECRETARY
4388 DELTA ST SUITE 3
SAN DIEGO CA 92113

Officer/Director/Trustee Five

SUZE LALANNE
TREASURER
4388 DELTA STREET SUITE 3
SAN DIEGO CA 92113

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/11/19
Organization Incorporation State CA
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: Yes
Educational: Yes
Scientific: Yes
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 OSSE MENARD
Signature Title PRESIDENT
Signature Date 3/31/19

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