FORM 1023-EZ for HIS WALK MEDIA INC

Field Data
EIN 47-2969716
Case Number EO-2015245-000308
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HIS WALK MEDIA INC
Organization’s Mailing Address 15 W MAIN ST UNIT B201
City NORWALK
State CT
ZIP 06851
Accounting period End 6
Primary contact name KEITH WOFSEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KEITH WOFSEY
VICE PRESIDENT
48 UNION ST STE 1C
STAMFORD CT 06906

Officer/Director/Trustee Two

MYKIM MATTHEWS
PRESIDENT
15 W MAIN ST UNIT B201
NORWALK CT 06851

Officer/Director/Trustee Three

TILSA GONZALEZ
TREASURER
28 FAIRMONT ST
ELMSFORD NY 10523

Officer/Director/Trustee Four

CECELIA DAVIS
SECRETARY
2208 IROQUOISE LANE
FALLS CHURCH VA 22043

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/5/2015
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A70 - Humanities Organizations
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
Signature Title
Signature Date

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