FORM 1023-EZ for GODS PROMISE IN HAITI

Field Data
EIN 81-1310256
Case Number EO-2016218-000163
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GODS PROMISE IN HAITI
Organization’s Mailing Address PO BOX 914
City MADISON
State MS
ZIP 39130
Accounting period End 12
Primary contact name ANTHONY DEAN HAINES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANTHONY HAINES
PRESIDENT
121 BRISAGE DRIVE
MADISON MS 39110

Officer/Director/Trustee Two

PATRICIA SMITH
TREASURER
1221 CLIFTEE DRIVE
BRENTWOOD TN 37027

Officer/Director/Trustee Three

LESLIE HAINES
BOARD MEMBER
121 BRISAGE DRIVE
MADISON MS 39110

Officer/Director/Trustee Four

CHARLES BORUM
BOARD MEMBER
20 TRAILS END ROAD
NATCHEZ MS 39120

Officer/Director/Trustee Five

DALE MORTON
BOARD MEMBER
4500 RIVER GREEN PARKWAY
DULUTH GA 30096

Organization’s website WWW.GODSPROMISEINHAITI.COM
Organization’s email GODSPROMISEINHAITI@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/17/2016
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
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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