FORM 1023-EZ for HEALTH EDUCATION 5 MINUTE STOP SMOKING PLAN INC

Field Data
EIN 82-3336911
Case Number EO-2018116-000141
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEALTH EDUCATION 5 MINUTE STOP SMOKING PLAN INC
Organization’s Mailing Address 9442 SYLMAR AVENUE APT 18
City PANORAMA
State CA
ZIP 91402
Accounting period End 12
Primary contact name JUDITH MIRANDA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JUDITH MIRANDA
PRESIDENT
9442 SYLMAR AVENUE APT 18
PANORAMA CA 91402

Officer/Director/Trustee Two

JEWEL MCKEEVER
TREASURER
9442 SYLMAR AVENUE APT 18
PANORAMA CA 91402

Officer/Director/Trustee Three

JAVIER OCAMPO
SECRETARY
9442 SYLMAR AVENUE APT 18
PANORAMA CA 91402

Officer/Director/Trustee Four

FREDDIE HARRIS
DIRECTOR
9442 SYLMAR AVENUE APT 18
PANORAMA CA 91402

Organization’s website
Organization’s email MIRANDAPANORAMA@AOL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/7/17
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E19 - Nonmonetary Support N.E.C.
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 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 JUDITH MIRANDA
Signature Title PRESIDENT
Signature Date 4/24/18

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