FORM 1023-EZ for HAITIAN UNITED EVANGELICAL MISSION

Field Data
EIN 82-4377983
Case Number EO-2018057-000462
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HAITIAN UNITED EVANGELICAL MISSION
Organization’s Mailing Address 222 NORTH 3RD ST PO BOX 1706
City IMMOKALEE
State FL
ZIP 34142
Accounting period End 12
Primary contact name LOUICESSE DORSAINT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LOUICESSE DORSAINT
DIRECTOR
306 WEST DELAWARE AVE
IMMOKALEE FL 34142

Officer/Director/Trustee Two

JUDITH BELIZAIRE
VICE PRESIDENT
306 WEST DELAWARE AVE
IMMOKALEE FL 34142

Officer/Director/Trustee Three

BERTRANDE CLERMONT
SECRETARY
3873 JUSTICE CIRCLE
IMMOKALEE FL 34142

Officer/Director/Trustee Four

WIKELSON DUMERVIL
TREASURER
1194 BANANA LN
IMMOKALEE FL 34142

Officer/Director/Trustee Five

RONALD DORSAINT
ADVISOR
306B WEST DELAWARE AVE
IMMOKALEE FL 34142

Organization’s website WWW.HAITIANUNITEDEVANGELICALMISSION.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/8/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X21 - Protestant
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name LOUICESSE DORSAINT
Signature Title DIRECTOR
Signature Date 2/23/18

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