FORM 1023-EZ for HEROES SMILE INC

Field Data
EIN 83-1087346
Case Number EO-2018234-000086
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEROES SMILE INC
Organization’s Mailing Address 100 TOWN CENTER ROAD SOUTH
City MOORESVILLE
State IN
ZIP 46158-2322
Accounting period End 7
Primary contact name DENNIS FRAZEE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DENNIS FRAZEE
PRESIDENT
5858 CHEROKEE DRIVE
BARGERSVILLE IN 46106

Officer/Director/Trustee Two

KRISTINA FRAZEE
TREASURER
5858 CHEROKEE DRIVE
BARGERSVILLE IN 46106

Organization’s website WWW.HEROESSMILEINC.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/28/18
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W80 - Public Utilities
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 Yes
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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DENNIS FRAZEE
Signature Title PRESIDENT
Signature Date 8/20/18

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