FORM 1023-EZ for HIS INTERNATIONAL INC

Field Data
EIN 46-4698690
Case Number EO-2016119-000355
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HIS INTERNATIONAL INC
Organization’s Mailing Address P O BOX 145 C/O LONG ACCOUNTING SER
City ELLIJAY
State GA
ZIP 30540
Accounting period End 12
Primary contact name IDA-MARIE LONG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RANDI GOULD
PRESIDENT
71 SHEFFIELD PLACE
CARTERSVILLE GA 30121

Officer/Director/Trustee Two

ERIN SCHINDLER
SECRETARY
400 UPPER CHERRYTOWN ROAD
KERHONKSON NY 12446

Officer/Director/Trustee Three

NONA CASH
VICE-PRESIDENT
4575 WOODVALLEY DRIVE
ACWORTH GA 30101

Officer/Director/Trustee Four

RICK CANNON
DIRECTOR
5353 SMOOTH MEADDOW WAY UNIT 2
COLUMBUS MD 21044

Officer/Director/Trustee Five

DIANA LEE
TREASURER
27 APPLE ROAD
NEW PALTZ NY 12561

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/20/2014
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X99 - Religion Related, Spiritual Development N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
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 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 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
Signature Title
Signature Date

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