FORM 1023-EZ for INTERFAITH HEALTHCARE PROVIDER NETWORK INC IHPN

Field Data
EIN 81-4492701
Case Number EO-2017145-000403
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name INTERFAITH HEALTHCARE PROVIDER NETWORK INC IHPN
Organization’s Mailing Address 625 RXR PLAZA SUITE 655
City UNIONDALE
State NY
ZIP 11556
Accounting period End 12
Primary contact name WIL EDVARD GERMAIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JACQUES GUILLAUME
DIRECTOR - PRESIDENT
625 RXR PLAZA SUITE 655
UNIONDALE NY 11556

Officer/Director/Trustee Two

WIL EDVARD GERMAIN
DIRECTOR - VICE PRESIDENT
1545 ATLANTIC AVE
BROOKLYN NY 11213

Officer/Director/Trustee Three

EMMANUEL BRUNOT
DIRECTOR - SECRETARY
1545 ATLANTIC AVE
BROOKLYN NY 11213

Organization’s website
Organization’s email WILGERMAIN13@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/11/2017
Organization Incorporation State NY
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 No
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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