FORM 1023-EZ for ROSE HEART MEMORIAL FUND INC

Field Data
EIN 83-1263576
Case Number EO-2018204-000417
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ROSE HEART MEMORIAL FUND INC
Organization’s Mailing Address 129 OAKLEY WAY
City DALLAS
State GA
ZIP 30132
Accounting period End 12
Primary contact name COURTNEY THORNHILL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

COURTNEY THORNHILL
PRESIDENT
129 OAKLEY WAY
DALLAS GA 30132

Officer/Director/Trustee Two

TRACY CHMELECKI
VICE PRESIDENT
2458 ROBIN HOOD PLACE
MARIETTA GA 30068

Officer/Director/Trustee Three

AMY PITTS
SECRETARY
4180 BURNT HICKORY RD NW
MARIETTA GA 30064

Organization’s website WWW.ROSEHEARTMEMORIAL.COM
Organization’s email COURTNEY@ROSEHEARTMEMORIAL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/4/18
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P12 - 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 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 COURTNEY THORNHILL
Signature Title PRESIDENT
Signature Date 7/20/18

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