FORM 1023-EZ for URBAN CARE OF HAITI

Field Data
EIN 81-1074051
Case Number EO-2016039-000063
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name URBAN CARE OF HAITI
Organization’s Mailing Address 332 BRIARGROVE ST
City GRETNA
State LA
ZIP 70056
Accounting period End 12
Primary contact name MIRTIL FELISNOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MIRTIL FELISNOR
PRESIDENT
332 BRIARGROVE ST
GRETNA LA 70056

Officer/Director/Trustee Two

BENITAL BIEN AIME
VICE PRESIDENT
733 CARROLLWOOD VILLAGE DR
GRETNA LA 70056

Officer/Director/Trustee Three

FEDEME BELANCE
TREASURY
2320 CAROL SUE AVE
GRETNA LA 70056

Officer/Director/Trustee Four

JOSEPH LAVENTURE
SECRETARY
1852 FAITH PLACE
GRETNA LA 70056

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/21/2015
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S32 - Rural Development
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 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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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