FORM 1023-EZ for HAITIAN CHAMBER OF COMMERCE FOUNDATION INC

Field Data
EIN 84-2470693
Case Number EO-2019207-000235
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HAITIAN CHAMBER OF COMMERCE FOUNDATION INC
Organization’s Mailing Address 75 ARLINGTON STREET SUITE 500
City BOSTON
State MA
ZIP 2116
Accounting period End 12
Primary contact name RICHARD CHAMPAGNE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RICHARD CHAMPAGNE
PRESIDENT
18 SARAH STREET
RANDOLPH MA 2368

Officer/Director/Trustee Two

VEDNA LACOMBE-HEYWOOD
VICE-PRESIDENT
9 NATHAN LANE
PLYMOUTH MA 2322

Officer/Director/Trustee Three

DIMITRY ADONIS
TREASURER
24 GLENDOWDER STREET
AVON MA 2322

Officer/Director/Trustee Four

THERVELAND DEROSIER
CLERK
16 PARK STREET
RANDOLPH MA 2368

Officer/Director/Trustee Five

STANLEY FANFAN
DIRECTOR
215 WOLOMOLOPOAG
SHARON MA 2067

Organization’s website WWW.HACCM.ORG
Organization’s email RICHARD.CHAMPAGNE@HACCM.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/22/19
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M40 - Safety Education
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 RICHARD CHAMPAGNE
Signature Title PRESIDENT
Signature Date 7/24/19

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