FORM 1023-EZ for SOUTHERN HEARTS

Field Data
EIN 81-4090619
Case Number EO-2017054-000274
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SOUTHERN HEARTS
Organization’s Mailing Address 499 STEWART STREET
City WELCH
State WV
ZIP 24801
Accounting period End 12
Primary contact name MELISSA CLARK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MELISSA CLARK
EXECUTIVE DIRECTOR
499 STEWART STREET
WELCH WV 24801

Officer/Director/Trustee Two

ANGELA WORKMAN
SECRETARY
PO BOX 455
KIMBALL WV 24853

Officer/Director/Trustee Three

JOEL MCKINNEY
TREASURER
499 STEWART STREET
WELCH WV 24801

Organization’s website
Organization’s email SOUTHERNHEARTS@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/1/2016
Organization Incorporation State WV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (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 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 Yes
One Third Support Gifts No
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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