FORM 1023-EZ for PHIAS HEART

Field Data
EIN 82-2051956
Case Number EO-2017186-000181
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PHIAS HEART
Organization’s Mailing Address 15507 S NORMANDIE AVE SUITE 509
City GARDENA
State CA
ZIP 90247
Accounting period End 12
Primary contact name ORELL E JONES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ORELL JONES
EXECUTIVE DIRECTOR
15507 S NORMANDIE AVE SUITE 509
GARDENA CA 90247

Officer/Director/Trustee Two

MONICA KING
BOARD PRESIDENT
15507 S NORMANDIE AVE SUITE 509
GARDENA CA 90247

Officer/Director/Trustee Three

SHAY MCGUIRE
BOARD TREASURER
15507 S NORMANDIE AVE SUITE 509
GARDENA CA 90247

Officer/Director/Trustee Four

SHAUNEE DOUGLAS
BOARD SECRETARY
15507 S NORMANDIE AVE SUITE 509
GARDENA CA 90247

Officer/Director/Trustee Five

VICTOR ROBERTS
BOARD MEMBER
15507 S NORMANDIE AVE SUITE 509
GARDENA CA 90247

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/19/2017
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: Yes
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
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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