FORM 1023-EZ for THE BOBBY HENLINE FOUNDATION

Field Data
EIN 83-4615262
Case Number EO-2019165-000147
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE BOBBY HENLINE FOUNDATION
Organization’s Mailing Address 455 SUNNEHANNA DRIVE UNIT 431
City MYRTLE BEACH
State SC
ZIP 29588
Accounting period End 12
Primary contact name JAMIE BURTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMIE BURTON
DIRECTOR AND PRESIDENT
455 SUNNEHANNA DRIVE UNIT 431
MYRTLE BEACH SC 29588

Officer/Director/Trustee Two

ROBERT HENLINE
DIRECTOR/VP/TREASURER
2030 OWLS NEST ROAD
SANFORD NC 27330

Officer/Director/Trustee Three

SHAWN FORD
DIRECTOR AND SECRETARY
141 HEATHERTON CIRCLE
GREENSBURG KY 42743

Organization’s website WWW.FORGINGFORWARD.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/3/19
Organization Incorporation State SC
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: 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 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 JAMIE BURTON
Signature Title DIRECTOR AND PRESIDENT
Signature Date 6/12/19

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