FORM 1023-EZ for BLACK HEART YOUTH FOUNDATION

Field Data
EIN 85-0876702
Case Number EO-2020134-000338
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK HEART YOUTH FOUNDATION
Organization’s Mailing Address 5721 BLOSSOM RD
City KNOXVILLE
State TN
ZIP 37912
Accounting period End 12
Primary contact name TONY ROGERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TONY ROGERS
OFFICER
5721 BLOSSOM RD
KNOXVILLE TN 37912

Officer/Director/Trustee Two

DWIGHT HUNDLEY
EXECUTIVE VICE PRESIDENT
5721 BLOSSOM RD
KNOXVILLE TN 37912

Organization’s website
Organization’s email BLACKHEARTYOUTHFOUNDATION@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/29/2020
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N65 - Football Clubs, Leagues
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TONY ROGERS
Signature Title OFFICER
Signature Date 5/11/2020

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