FORM 1023-EZ for HAITI CHOLERA RESEARCH FUNDING FOUNDATION INC

Field Data
EIN 46-3860027
Case Number EO-2018247-000396
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HAITI CHOLERA RESEARCH FUNDING FOUNDATION INC
Organization’s Mailing Address 4700 LUCERNE LAKES BLVD WEST 604
City LAKE WORTH
State FL
ZIP 33467
Accounting period End 12
Primary contact name PIERRETTE J JCAZEAU
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PIERRETTE J CAZEAU
PRESIDENT & CEO
4700 LUCERNE LAKES BLVD WEST 604
LAKE WORTH FL 33467

Officer/Director/Trustee Two

THOMAS F HUEHN
VICE-PRESIDENT
4700 LUCERNE LAKES BLVD WEST 604
LAKE WORTH FL 33467

Officer/Director/Trustee Three

CHRISTA DEWI
BOARD & OFFICER
VILLA TANAH EMASC 2 DEGGUNG
YOGYAKARTA

Officer/Director/Trustee Four

SUNETH B AGAMPODI
BOARD & CHAIR
388128A HARISH CHANDRANWSTAGE1
ANURADHAPURA

Organization’s website WWW.HCRFF.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/2/13
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 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 Yes
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name PIERRETTE J CAZEAU
Signature Title PRESIDENT & CEO
Signature Date 8/30/18

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