FORM 1023-EZ for SAMARITANS HEART MINISTRIES INC

Field Data
EIN 81-2152069
Case Number EO-2018141-000479
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SAMARITANS HEART MINISTRIES INC
Organization’s Mailing Address PO BOX 3062
City DAPHNE
State AL
ZIP 36526
Accounting period End 12
Primary contact name PATRICK COLLINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICK COLLINS
CHAIRMAN
PO BOX 3062
DAPHNE AL 36526

Officer/Director/Trustee Two

CRAIG BUSCHER
DIRECTOR
10975 NE 80TH ST
BONDURANT IA 50035

Officer/Director/Trustee Three

MARK BUHLIG
DIRECTOR
226 N JEWELL ST
LIBERTY MO 64068

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/8/16
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
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 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 PATRICK COLLINS
Signature Title CHAIRMAN
Signature Date 5/17/18

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