| Field | Data |
|---|---|
| EIN | 47-2631316 |
| Case Number | EO-2017250-000392 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | MENTARI HUMAN TRAFFICKING SURVIVOR EMPOWERMENT PROGRAM INC |
| Organization’s Mailing Address | 19-43 79 STREET |
| City | EAST ELMHURST |
| State | NY |
| ZIP | 11370 |
| Accounting period End | 11 |
| Primary contact name | RANDALL ROCA |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
SHANDRA WOWORUNTU
PRESIDENT
4503 JUNCTION BLVD APT 2
CORONA NY 11368
RANDALL ROCA
VICE PRESIDENT
19-43 79 STREET
EAST ELMHURST NY 11370
| Organization’s website | WWW.MENTARIUSA.ORG |
|---|---|
| Organization’s email | MENTARIUSA@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 12/2/2014 |
| Organization Incorporation State | NY |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P62 - Victims' 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 | Yes |
| 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 | Yes |
| One Third Support Gifts | No |
| Benefit of College | No |
| Private Foundation 508(e) | No |
| Seeking Retroactive Reinstatement | Yes |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | |
| Signature Title | |
| Signature Date | |
| EIN | 47-2631316 |
| Case Number | EO-2015037-000176 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | MENTARI HUMAN TRAFFICKING SURVIVOREMPOWERMENT PROGRAM INC |
| Organization’s Mailing Address | 19-43 79 STREET |
| City | EAST ELMHURST |
| State | NY |
| ZIP | 11370-1311 |
| Accounting period End | 12 |
| Primary contact name | CHRIS HEUERTZ |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
SHANDRA WOWORUNTU
PRESIDENT
4503 JUNCTION BLVD APT 2
CORONA NY 11368
RANDALL ROCA
VICE PRESIDENT
19-43 79 STREET
EAST ELMHURST NY 11370-1311
IMA MATUL
TREASURER
545 MANHATTAN PLACE APT 9
LOS ANGELES CA 90020
CHRIS HEUERTZ
SECRETARY
137 NORTH 33 STREET APT D
OMAHA NE 68131
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 12/2/2014 |
| Organization Incorporation State | NY |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P62 - Victims' 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 | Yes |
| Donation of funds | Yes |
| 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 | 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 | |
| Signature Title | |
| Signature Date |
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