FORM 1023-EZ for CLINIC FOR HOPE AND HEALING INC

Field Data
EIN 82-2004857
Case Number EO-2018140-000082
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CLINIC FOR HOPE AND HEALING INC
Organization’s Mailing Address 8778 PAULETTE PLACE
City BILOXI
State MS
ZIP 39532
Accounting period End 12
Primary contact name JAMES HAYNES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES HAYNES
PRESIDENT/DIRECTOR
8778 PAULETTE PLACE
BILOXI MS 39532

Officer/Director/Trustee Two

BENJAMIN LENDENNIE
VICE-PRESIDENT/DIRECTOR
586 PRESTWORTH DR
COLLIERVILLE MS 38017

Officer/Director/Trustee Three

MINDY BEVERIAN
SECRETARY/DIRECTOR
3527 BRANDON JAMES DR
BILOXI MS 39532

Officer/Director/Trustee Four

BOB COLLINS
TREASURER/DIRECTOR
2527 ORLEANS RD
BILOXI MS 39631

Officer/Director/Trustee Five

HEATH HILMAN
DIRECTOR
3308 NORTH 5TH STREET
OCEAN SPRINGS MS 39564

Organization’s website
Organization’s email JHAYNES4492@AOL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/1/17
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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 Yes
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JAMES HAYNES
Signature Title PRESIDENT/DIRECTOR
Signature Date 5/15/18

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