FORM 1023-EZ for HEARTPACK INC

Field Data
EIN 84-3008368
Case Number EO-2019273-000287
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEARTPACK INC
Organization’s Mailing Address 35C 10TH AVENUE
City KEY WEST
State FL
ZIP 33040
Accounting period End 12
Primary contact name LINDA M ANDERSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAYLA BARR
PRESIDENT
704 GALVESTON LANE
KEY WEST FL 33040

Officer/Director/Trustee Two

OAKLEIGH WAITS
VICE PRESIDENT
1420 6TH STREET
KEY WEST FL 33040

Officer/Director/Trustee Three

SUSAN BEALE
SECRETARY
1011 CATHERINE STREET
KEY WEST FL 33040

Officer/Director/Trustee Four

LINDA ANDERSEN
TREASURER
1414 ANGELA STREET
KEY WEST FL 33040

Organization’s website HEARTPACK.ORG
Organization’s email LINDA@HEARTPACK.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/9/19
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M12 - Fund Raising and/or Fund Distribution
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 Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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 LINDA ANDERSEN
Signature Title TREASURER
Signature Date 9/26/19

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