FORM 1023-EZ for HANK ADKINS HERO FUND

Field Data
EIN 47-4396764
Case Number EO-2015216-000415
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HANK ADKINS HERO FUND
Organization’s Mailing Address 4617 BUCYRUS AVE
City CLEVELAND
State OH
ZIP 44109
Accounting period End 5
Primary contact name BETH PACE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CYNTHIA RICE
PRESDIENT
4617 BUCYRUS AVE
CLEVELAND OH 44109

Officer/Director/Trustee Two

BETH PACE
TREASURER
3440 BROOKVIEW BLVD
PARMA OH 44134

Officer/Director/Trustee Three

MANUELA ISTOK
SECRETARY
3734 WEST 169TH STREET
CLEVELAND OH 44111

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/28/2015
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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 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
Signature Title
Signature Date

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