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2012 Exempt Organization Business Tax Return prepared for: Haiti Health Initiative 44 E 1430 N Orem, UT 84057 LJCooper Tax Strategies 499 South Orem Blvd Orem, UT 84058 Form Short Form Return of Organization

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2012 2011 Utah 990-EZ Orem FMV Grantees preparer ERO OMB 16a TEEA0812 8879-EO 16b 17a Stmt 990-PF e-file nonexempt 1120-POL Timo Ellsworth 10-facts-and-circumstances W-2 Reportable 1099-MISC preparers EIN Whipple 10b 17b 19a EFIN

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