FORM 1023-EZ for HAITIAN INSTITUTE FOR WELLNESS

Field Data
EIN 47-2544454
Case Number EO-2021127-000176
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HAITIAN INSTITUTE FOR WELLNESS
Organization’s Mailing Address 925
City MEDFORD
State MA
ZIP 02155
Accounting period End 7
Primary contact name SHEILA LEGRAND
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHEILA LEGRAND
DIRECTOR
171 N END RD
TOWNSEND MA 01469-1122

Officer/Director/Trustee Two

JUDITH ALCE
DIRECTOR
66 SMITH ST
FITCHBURG MA 02140-7354

Officer/Director/Trustee Three

YANDI PIERRE
SECRETARY
1 COLLEGE ST 2454
WORCESTER MA 01610-2395

Organization’s website WWW.HIFW.ORG
Organization’s email SLEGRAND@HIFW.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/23/2014
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S99 - Community Improvement, Capacity Building N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: Yes
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 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 Yes
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 SHEILA LEGRAND
Signature Title DIRECTOR
Signature Date 5/5/2021

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