FORM 1023-EZ for MISSION II HAITI INC

Field Data
EIN 45-2699992
Case Number EO-2017121-000311
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MISSION II HAITI INC
Organization’s Mailing Address 1102 W 21ST ST
City KEARNEY
State NE
ZIP 68845-5161
Accounting period End 6
Primary contact name GREG HOFFMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBERT EASTON
PRESIDENT TREASURER
1102 W 21ST ST
KEARNEY NE 68845-5161

Officer/Director/Trustee Two

ROGER HOFFMAN
VICE PRESIDENT
1104 E 56TH ST NO 19
KEARNEY NE 68847

Officer/Director/Trustee Three

HANNAH STONE
VICE PRESIDENT
4 HILLCREST DR
KEARNEY NE 68845

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/28/2011
Organization Incorporation State NE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
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 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

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