FORM 1023-EZ for ETHELS HEART INC

Field Data
EIN 47-2892476
Case Number EO-2015119-000300
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ETHELS HEART INC
Organization’s Mailing Address 2106 E FRIERSON AVENUE
City TAMPA
State FL
ZIP 33610
Accounting period End 12
Primary contact name SHAUNETTE STOKES ESQ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KATINA BRYANT
PRESIDENT
2106 E FRIERSON AVENUE
TAMPA FL 33610

Officer/Director/Trustee Two

TARANCE LENOIR
VICE PRESIDENT
4891 PURITAN CIRCLE
TAMPA FL 33617

Officer/Director/Trustee Three

TIARRA ANDERSON
TREASURER
4014 CINDER BEND DRIVE
TAMPA FL 33610

Officer/Director/Trustee Four

ANTHONY TURNER
SECRETARY
19007 CHEMILLE DRIVE
LUTZ FL 33558

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/20/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
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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