FORM 1023-EZ for HEAVENS ELEVEN INC

Field Data
EIN 81-1314768
Case Number EO-2017093-000188
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEAVENS ELEVEN INC
Organization’s Mailing Address 4733 RALEIGH ROAD
City HENDERSON
State NC
ZIP 27537
Accounting period End 12
Primary contact name CHARLES E POWELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHARLES POWELL
DIRECTOR/PRESIDENT
4733 RALEIGH ROAD
HENDERSON NC 27537

Officer/Director/Trustee Two

BENJAMIN POWELL
DIRECTOR/VICE-PRESIDENT
4733 RALEIGH ROAD
HENDERSON NC 27537

Officer/Director/Trustee Three

COURTNEY STAINBACK-DEPO
DIRECTOR/SECRETARY
162 DK STAINBACK ROAD
HENDERSON NC 27537

Officer/Director/Trustee Four

DEBORAH POWELL
DIRECTOR/TREASURER
4733 RALEIGH ROAD
HENDERSON NC 27537

Officer/Director/Trustee Five

ERIC STAINBACK
DIRECTOR
264 DK STAINBACK ROAD
HENDERSON NC 27537

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/19/2016
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K20 - Agricultural Programs
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 No
One Third Support Gifts Yes
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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