FORM 1023-EZ for LEXI SIMAS HEARTSAVERS FOUNDATION

Field Data
EIN 82-5077684
Case Number EO-2018164-000183
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LEXI SIMAS HEARTSAVERS FOUNDATION
Organization’s Mailing Address 1209 TIPPERARY DR
City MELBOURNE
State FL
ZIP 32940
Accounting period End 12
Primary contact name STACEY SIMA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STACEY SIMA
PRESIDENT
1209 TIPPERARY DR
MELBOURNE FL 32940

Officer/Director/Trustee Two

SHAWN SIMA
VICE PRESIDENT
1209 TIPPERARY DR
MELBOURNE FL 32940

Officer/Director/Trustee Three

ALEXA SIMA
SECRETARY
1209 TIPPERARY DR
MELBOURNE FL 32940

Officer/Director/Trustee Four

CARTER SIMA SIMA
TRUSTEE
1209 TIPPERARY DR
MELBOURNE FL 32940

Organization’s website WWW.LEXISHEARTSAVERS.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/10/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S80 - Community Service Clubs
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 STACEY SIMA
Signature Title PRESIDENT
Signature Date 6/11/18

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