FORM 1023-EZ for ALIVE IN MY HEART

Field Data
EIN 82-1529822
Case Number EO-2017173-000303
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ALIVE IN MY HEART
Organization’s Mailing Address PO BOX 16912
City COLUMBUS
State OH
ZIP 43216
Accounting period End 12
Primary contact name KESSIA CERICOLA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KESSIA CERICOLA
PRESIDENT
367 GIOVANNA AVE
COLUMBUS OH 43201

Officer/Director/Trustee Two

KERRY JANIDLO
VICE PRESIDENT
109 BEECH CT
DELAWARE OH 43015

Officer/Director/Trustee Three

AJ CERICOLA
TREASURER
367 GIOVANNA AVE
COLUMBUS OH 43201

Officer/Director/Trustee Four

ELIZABETH YASSENOFF
SECRETARY
2012 TREMONT RD
COLUMBUS OH 43221

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/9/2017
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P50 - Personal Social Services
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 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
Signature Title
Signature Date

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