FORM 1023-EZ for MEDICAL MISSION FOR HAITI

Field Data
EIN 83-0674757
Case Number EO-2020108-000091
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MEDICAL MISSION FOR HAITI
Organization’s Mailing Address 2200 N SHERMAN CIRCLE APT 403
City MIRAMAR
State FL
ZIP 33025
Accounting period End 12
Primary contact name EMMANUEL THOMAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EMMANUEL THOMAS
PRESIDENT
2200 NORTH SHERMAN CIRCLE APT 403
MIRAMAR FL 33025-5156

Officer/Director/Trustee Two

MARLEINE PEOPLES
SECRETARY
2200 NORTH SHERMAN CIRCLE APT 403
MIRAMAR FL 33025-5156

Officer/Director/Trustee Three

MICHEL RONALD DESAMOURS
TREASURER
2200 NORTH SHERMAN CIRCLE APT 403
MIRAMAR FL 33025-5156

Organization’s website WWW.MEDICALMISSIONFORHAITI.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/21/2018
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Q30 - International Development, Relief Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 EMMANUEL THOMAS
Signature Title PRESIDENT
Signature Date 4/15/2020

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