FORM 1023-EZ for HARRELL KAGLER INTERVENTIONS INC

Field Data
EIN 81-1932121
Case Number EO-2016356-000097
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HARRELL KAGLER INTERVENTIONS INC
Organization’s Mailing Address 12672 LIMONITE AVENUE 3E-118
City EASTVALE
State CA
ZIP 92880
Accounting period End 3
Primary contact name DR JAMILLE HARRELL-SIMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DR JAMILLE HARRELL-SIMS
CEO
12672 LIMONITE STE 3E-118
EASTVALE CA 92880

Officer/Director/Trustee Two

DR FIESTA KAGLER
COO
210 PEBBLE BROOK COURT
COVINGTON GA 30016

Officer/Director/Trustee Three

JAMES P HARRELL-SIMS
CFO
322 S MARENGO
PASADENA CA 91101

Organization’s website HARRELLKAGLERINTERVENTIONS.ORG
Organization’s email JHARRELLSIMS15@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/25/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
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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