FORM 1023-EZ for INTO HIS IMAGE

Field Data
EIN 82-3735809
Case Number EO-2019191-000364
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name INTO HIS IMAGE
Organization’s Mailing Address 25050 CYPRESS HOLLOW CT APT 203
City BONTIA SPRINGS
State FL
ZIP 34134
Accounting period End 12
Primary contact name WARREN KOOI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHRISTOPHER HALL
TREASURER
6540 TRAIL BLVD
NANPLES FL 34108

Officer/Director/Trustee Two

PAMELA FORBUS
SECRETARY
185 ELMWOOD LANE
NAPLES FL 34112

Officer/Director/Trustee Three

WARREN KOOI
PRESIDENT
25050 CYPRESS HOLLOW COURT APT 203
BONTIA SPRINGS FL 34134

Organization’s website
Organization’s email INFO@INTOHISIMAGE.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
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 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name WARREN KOOI
Signature Title PRESIDENT
Signature Date 7/8/19

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