FORM 1023-EZ for HI-5S HUGS FOR HYDROCEPHALUS INC

Field Data
EIN 82-1016825
Case Number EO-2017317-000575
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HI-5S HUGS FOR HYDROCEPHALUS INC
Organization’s Mailing Address 1201 44TH STREET NORTH
City BIRMINGHAM
State AL
ZIP 35212
Accounting period End 12
Primary contact name J DANIEL LEVERTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CRYSTAL MCCRAY
PRESIDENT DIRECTOR
1201 44TH STREET NORTH
BIRMINGHAM AL 35212

Officer/Director/Trustee Two

DERICK POWELL
DIRECTOR
1201 44TH STREET NORTH
BIRMINGHAM AL 35212

Officer/Director/Trustee Three

KENYA RAWLS
SECRETARY DIRECTOR
3913 TALWELL DRIVE APT 6
HUNTSVILLE AL 35805

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/15/2017
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G48 - Brain Disorders
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 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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