FORM 1023-EZ for TEMS PEOPLES HEALTH INITIATIVE

Field Data
EIN 82-2019526
Case Number EO-2017184-000252
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TEMS PEOPLES HEALTH INITIATIVE
Organization’s Mailing Address 15730
City WASHINGTON
State DC
ZIP 20003
Accounting period End 12
Primary contact name STEPHANIE VANN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEPHANIE VANN
BOARD MEMBER/PRESIDENT
706 12TH STREET SE APT 12
WASHINGTON DC 20003

Officer/Director/Trustee Two

KAYODE MOSLEY
BOARD MEMBER/SECRETARY/TRESSURER
1525 NEWTON STREET NW G1
WASHINGTON DC 20010

Officer/Director/Trustee Three

ISAAC PETWAY
BOARD MEMBER/CHAIR OF THE BOARD
2307 CHAMPLAIN ST NW APT 701
WASHINGTON DC 20009

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/29/2017
Organization Incorporation State DC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code J99 - Employment, Job Related 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 No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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