FORM 1023-EZ for HOLLISTIC MENTAL HEALTH NETWORK IMAN

Field Data
EIN 85-0911768
Case Number EO-2020128-000081
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HOLLISTIC MENTAL HEALTH NETWORK IMAN
Organization’s Mailing Address 2060 COOLIDGE DRIVE
City SANTA CLARA
State CA
ZIP 95051
Accounting period End 12
Primary contact name IMAN FARAJALLAH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

IMAN FARAJALLAH
DIRECTOR
2060 COOLIDGE DRIVE
SANTA CLARA CA 95051

Officer/Director/Trustee Two

DOA MORSY
DIRECTOR
175 BAYPOINTE PARKWAY APT 460
SAN JOSE CA 95143

Officer/Director/Trustee Three

CHRISTIAN BYRON VAIL
DIRECTOR
1189 BLAZINGWOOD DR
SUNNYVALE CA 94089

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/3/2020
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F80 - Mental Health Association, 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 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 IMAN FARAJALLAH
Signature Title DIRECTOR
Signature Date 5/5/2020

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