FORM 1023-EZ for UNITED HAITIAN ORTHOPAEDIC PHILANTHROPISTS INC

Field Data
EIN 81-0751766
Case Number EO-2016181-000066
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name UNITED HAITIAN ORTHOPAEDIC PHILANTHROPISTS INC
Organization’s Mailing Address 1355 CAMELBACK DR
City POCATELLO
State ID
ZIP 83201
Accounting period End 12
Primary contact name STEPHEN M HANSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

STEPHEN HANSEN
DIRECTOR
1355 CAMELBACK DR
POCATELLO ID 83201

Officer/Director/Trustee Two

EMILY HANSEN
DIRECTOR
1355 CAMBELBACK DR
POCATELLO ID 83201

Officer/Director/Trustee Three

MICHAEL HANSEN
DIRECTOR
1355 CAMELBACK DR
POCATELLO ID 83201

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/3/2015
Organization Incorporation State ID
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
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 Yes
Conducting Activities Outside of United States Yes
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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