FORM 1023-EZ for HEALING HEART HAVEN FOR ANIMALS

Field Data
EIN 84-1995055
Case Number EO-2019158-000313
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEALING HEART HAVEN FOR ANIMALS
Organization’s Mailing Address 5120 LINCOLN AVE APT 218
City CYPRESS
State CA
ZIP 90630-2982
Accounting period End 12
Primary contact name JEANNE M MCCLELLAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEANNE MCCLELLAN
CHIEF OPERATING OFFICER
5120 LINCOLN AVE APT 218
CYPRESS CA 90630-2982

Officer/Director/Trustee Two

BARBARA HAMZA
SECRETARY
465 FAIR DRIVE APT 205
COSTA MESA CA 92626-6225

Officer/Director/Trustee Three

MAUREEN GRAGNANI
BOARD MEMBER
5791 LUDLOW AVE
GARDEN GROVE CA 92845-2014

Officer/Director/Trustee Four

POLLY ERNST
TREASURER
6111 KILLARNEY AVE
GARDEN GROVE CA 92845-2729

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/22/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D20 - Animal Protection and Welfare
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 JEANNE MCCLELLAN
Signature Title CHIEF OPERATING OFFICER
Signature Date 6/5/19

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