FORM 1023-EZ for MATE TESOL HAITI

Field Data
EIN 98-1044676
Case Number EO-2015057-000080
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MATE TESOL HAITI
Organization’s Mailing Address 80 HARRIS PLACE APARTMENT 162
City FREMONT
State CA
ZIP 94536-1780
Accounting period End 6
Primary contact name JEAN ITALIEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JEAN ITALIEN
DIRECTOR AND PRESIDENT/CEO
80 HARRIS PLACE APARTMENT 162
FREMONT CA 94536-1780

Officer/Director/Trustee Two

COMFORT DAVIS MINGOT
DIRECTOR AND SECRETARY
11628 LOCKWOOD DRIVE APT 301
SILVER SPRING MD 20904-2331

Officer/Director/Trustee Three

COLBERT COURTOIS
DIRECTOR AND TREASURER/CFO
7 LOUNDSBURY AVENUE
NORWALK CT 06851-4513

Organization’s website WWW.TESOL-HAITI.ORG
Organization’s email ITALIEN_JEANFRANTZY@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/27/2014
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A70 - Humanities Organizations
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 Yes
Donation of funds No
Conducting Activities Outside of United States Yes
Financial transactions with officers Yes
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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