FORM 1023-EZ for HEART AND SOUL MINISTRY

Field Data
EIN 81-3542048
Case Number EO-2017111-000296
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEART AND SOUL MINISTRY
Organization’s Mailing Address 8345 PEPPERWOOD COURT
City JACKSONVILLE
State FL
ZIP 32244
Accounting period End 12
Primary contact name MICHELLE JOY NIXON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHELLE NIXON
DIRECTOR/PRESIDENT
13364 BEACH BLVD UNIT 635
JACKSONVILLE FL 32224

Officer/Director/Trustee Two

VALENTINA GILLESPIE
VICE PRESIDENT/TREASURER
2556 WATERMILL DRIVE
ORANGE PARK FL 32073

Officer/Director/Trustee Three

KEVIN COPELAND
VICE PRESIDENT
534 CAPTIVA DRIVE
PONTE VEDRA FL 32081

Officer/Director/Trustee Four

CINDY MASON
SECRETARY
8345 PEPPERWOOD COURT
JACKSONVILLE FL 32244

Organization’s website HTTP://WWW.HEARTANDSOULMINISTRY.COM
Organization’s email MICHELLEJOYNIXON@JOYISINYOU.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/9/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S80 - Community Service Clubs
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 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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