FORM 1023-EZ for ARKANSAS HISPANIC HEALTH COALITIONINC

Field Data
EIN 46-5598485
Case Number EO-2016078-000219
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ARKANSAS HISPANIC HEALTH COALITIONINC
Organization’s Mailing Address PO BOX 5117
City CONWAY
State AR
ZIP 72035
Accounting period End 12
Primary contact name MANNY SEPULVEDA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

NICK RIOS
PRESIDENT
2 JANWOOD DRIVE
LITTLE ROCK AR 72227-5831

Officer/Director/Trustee Two

DANNY VASQUES
VICE-PRESIDENT
2020 W 3RD STREET
LITTLE ROCK AR 72205-4461

Officer/Director/Trustee Three

MANNY SEPULVEDA
SECRETARY-TREASURER
1515 SOUTH BLVD
CONWAY AR 72034-6450

Organization’s website ARKANSASHISPANICHEALTH.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/21/2014
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code R01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence Yes
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 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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