FORM 1023-EZ for HEALTHY MINDS INITIATIVE

Field Data
EIN 82-2971749
Case Number EO-2017303-000120
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEALTHY MINDS INITIATIVE
Organization’s Mailing Address 831 LA SOLANA DR
City REDLAND
State CA
ZIP 92373
Accounting period End 12
Primary contact name DEAN SHERZAI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEAN SHERZAI
PRESIDENT
831 LA SOLANA DR
REDLAND CA 92373

Officer/Director/Trustee Two

AYESHA SHERAZI
TREASURER
831 LA SOLANA DR
REDLAND CA 92373

Officer/Director/Trustee Three

MARYLOU MARQUEZ
SECRETARY
11660 CHURCH STREET 161 BUILDING 3
RANCHO CUCAMONGA CA 91730

Organization’s website WWW.HEALTHYMINDSINITIATIVE.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/22/2017
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H48 - Brain Disorders Research
Organization’s purpose Charitable: Yes
Religious: No
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
Signature Title
Signature Date

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