FORM 1023-EZ for SLO HEART FOUNDATION

Field Data
EIN 82-1464913
Case Number EO-2017198-000161
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SLO HEART FOUNDATION
Organization’s Mailing Address 1160 GRASSY HOLLOW WAY
City PASO ROBLES
State CA
ZIP 93446
Accounting period End 12
Primary contact name ROBERT DANIEL CARRIGAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBERT DANIEL CARRIGAN
PRESIDENT/DIRECTOR
1160 GRASSY HOLLOW WAY
PASO ROBLES CA 93446

Officer/Director/Trustee Two

PEGGY CARRIGAN
TREASURER/DIRECTOR
1160 GRASSY HOLLOW WAY
PASO ROBLES CA 93446

Officer/Director/Trustee Three

KAREN PATTERSON
SECRETARY/DIRECTOR
1241 VISTA DE LA MONTANA
PASO ROBLES CA 93405

Officer/Director/Trustee Four

PATRICK SHEEAN
DIRECTOR
959 WALNUT DR
PASO ROBLES CA 93446

Officer/Director/Trustee Five

NICOLE MORELAND
DIRECTOR
2728 STONEBROOK CIRCLE
PASO ROBLES CA 93446

Organization’s website
Organization’s email SLOHEARTFOUNDATION@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/19/2017
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G43 - Heart and Circulatory System Diseases, Disorders
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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