FORM 1023-EZ for CONTRITE HEART FUND INC

Field Data
EIN 81-1304714
Case Number EO-2016263-000251
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CONTRITE HEART FUND INC
Organization’s Mailing Address 19309 WINMEADE DRIVE 414
City LANSDOWNE
State VA
ZIP 20176
Accounting period End 12
Primary contact name AUTUMN D MCCULLOGH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GARY KYLE
PRESIDENT
43126 MEADOW GROVE DRIVE
ASHBURN VA 20147-6603

Officer/Director/Trustee Two

MICHAEL HOYES
TREASURER
212 SILVER FOX TERRACE
YORKTOWN VA 23693-3349

Officer/Director/Trustee Three

AUTUMN MCCULLOGH
SECRETARY
11350 RANDOM HILLS ROAD STE 500
FAIRFAX VA 22030-6604

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/24/2015
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - Fund Raising and/or Fund Distribution
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 Yes
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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