FORM 1023-EZ for FOUNDATION FOR ADVANCEMENT OF HAITIAN MIDWIFERY INCORPORATED

Field Data
EIN 46-5158314
Case Number EO-2014351-000168
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FOUNDATION FOR ADVANCEMENT OF HAITIAN MIDWIFERY INCORPORATED
Organization’s Mailing Address 136 WEST 81ST STREET GF
City NEW YORK
State NY
ZIP 10024
Accounting period End 12
Primary contact name KAREN JEFFERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARTINE JEAN-BAPTISTE
PRESIDENT
136 WEST 81 STREET GF
New York NY 10024

Officer/Director/Trustee Two

JOHANNA DE LOS SANTOS
VICE PRESIDENT
4130 SOUTH LAKE DRIVE APT 234
ST FRANCIS WI 53235

Officer/Director/Trustee Three

KAREN JEFFERSON
SECRETARY
688 PRESIDENT STREET
Brooklyn NY 11215

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/28/2014
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G02 - Management & Technical Assistance
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 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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