FORM 1023-EZ for LIFE FOR HAITI FOUNDATION INC

Field Data
EIN 47-5473052
Case Number EO-2015309-000101
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIFE FOR HAITI FOUNDATION INC
Organization’s Mailing Address 12115 SWEET CLOVER DRIVE
City SILVER SPRING
State MD
ZIP 20904
Accounting period End 12
Primary contact name THOMAS MOGHADDAM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JEAN C SYLVAIN
VICE PRESIDENT
12115 SWEET CLOVER DRIVE
SILVER SPRING MD 20904

Officer/Director/Trustee Two

MARIE E JOSEPH
SECRETARY
12115 SWEET CLOVER DRIVE
SILVER SPRING MD 20904

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/8/2015
Organization Incorporation State MD
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: Yes
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 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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