FORM 1023-EZ for PATIENT HOUSING ASSISTANCE INC

Field Data
EIN 83-1074210
Case Number EO-2019102-000127
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PATIENT HOUSING ASSISTANCE INC
Organization’s Mailing Address 3103 VILLA LANE
City MISSOURI CITY
State TX
ZIP 77459-2613
Accounting period End 12
Primary contact name YANNICK THOMAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TED ECHEMAN
DIRECTOR/PRESIDENT
180 FIELD BRIAR
KATY TX 77450

Officer/Director/Trustee Two

DAVID THOMAS
DIRECTOR/TREASURER
261 CARTWRIGHT ROAD SUITE D UNIT152
MISSOURI CITY TX 77459-2613

Officer/Director/Trustee Three

MONIKA BROWN
DIRECTOR/SECRETARY
15003 PROVIDENCE VALLEY CIR
CYPRESS TX 77429

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/21/18
Organization Incorporation State TX
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: 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 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 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 DAVID THOMAS
Signature Title DIRECTOR/TREASURER
Signature Date 4/10/19

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