FORM 1023-EZ for 3 HEARTS HEALING

Field Data
EIN 83-1201611
Case Number EO-2019035-001005
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name 3 HEARTS HEALING
Organization’s Mailing Address 568 NE SAVANNAH DR STE 2
City BEND
State OR
ZIP 97702
Accounting period End 12
Primary contact name DONNA M HINES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DONNA M HINES
PRESIDENT
568 NE SAVANNAH DR STE 2
BEND OR 97701

Officer/Director/Trustee Two

TAMRA L CHAPIN
SECRETARY
568 NE SAVANNAH DR STE 2
BEND OR 97701

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/18/18
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E86 - Patient Services - Entertainment, Recreation
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 Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
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 TAMRA L CHAPIN
Signature Title SECRETARY
Signature Date 1/15/19

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