FORM 1023-EZ for HEART ON A MISSION INCORPORATED

Field Data
EIN 47-4916014
Case Number EO-2016154-000217
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEART ON A MISSION INCORPORATED
Organization’s Mailing Address 128 BLEDSOE STREET
City HOPE MILLS
State NC
ZIP 28348
Accounting period End 3
Primary contact name LORNA GREEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CARRIE HOLMQUIST
PRESIDENT / EXECUTIVE DIRECTOR
5916 GILLINGHAM DRIVE
FORT BELVIOR VA 22060

Officer/Director/Trustee Two

VELMA GARCIA
SECRETARY
7340 WATERWHEEL STREET
COLORADO SPRINGS CO 80911

Officer/Director/Trustee Three

GIOIA GILTZ
COMMUNITY RELATIONS DIRECTOR
9111 MURDOCK ROAD
FAIRFAX VA 22032

Officer/Director/Trustee Four

MANDI SCHOPPERT
COMMUNICATIONS DIRECTOR
536 CARRIAGE LANE
RAEFORD NC 28376

Officer/Director/Trustee Five

VIOLET MC NERNEY
STRATEGIC DIRECTOR
8172 AMERICAN HOLLY ROAD
LORTON VA 22079

Organization’s website HTTPS://M.FACEBOOK.COM/HEARTSONAMISSION/
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/3/2015
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W30 - Military, Veterans' Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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