FORM 1023-EZ for EMBODIED HEALING TRAUMA INSTITUTE EHTI INC

Field Data
EIN 83-1604632
Case Number EO-2019092-000401
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EMBODIED HEALING TRAUMA INSTITUTE EHTI INC
Organization’s Mailing Address 126 ANAMOSA ST
City RAPID CITY
State SD
ZIP 57701
Accounting period End 12
Primary contact name JAYNE GRACE HALL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAYNE HALL
PRESIDENT
126 ANAMOSA STREET
RAPID CITY SD 57701

Officer/Director/Trustee Two

JOYLYNN FOLI
VICE PRESIDENT
11233 HARBORVALE CHASE
FISHERS IN 46023

Officer/Director/Trustee Three

HEIDI MECHAM
SECRETARY
2510 JANET STREET
RAPID CITY SD 57701

Organization’s website
Organization’s email EHTIRAPIDCITY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/5/18
Organization Incorporation State SD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - 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 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 JAYNE HALL
Signature Title PRESIDENT
Signature Date 3/30/19

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