FORM 1023-EZ for HEAVEN SENT ADULT DAY CARE CENTER

Field Data
EIN 47-1383045
Case Number EO-2015048-000115
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEAVEN SENT ADULT DAY CARE CENTER
Organization’s Mailing Address 27401 OAK ROAD
City HENSLEY
State AR
ZIP 72065
Accounting period End 12
Primary contact name LYNN WALLS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LYNN WALLS
DIRECTOR
27401 OAK ROAD
HENSLEY AR 72065

Officer/Director/Trustee Two

ANGELIA WRIGHT
DIRECTOR
2704 PATRICIA STREET
PINE BLUFF AR 71603

Officer/Director/Trustee Three

AVA BRADFORD
COO
1502 GREEN MOUNTAIN RD APT 292
LITTLE ROCK AR 72211

Officer/Director/Trustee Four

SHUNTA GRAHAM
SECRETARY/TREASURER
3720 MIRAMAR DR APT 18
PINE BLUFF AR 71603

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/30/2014
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P71 - Adult Daycare
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: No
Literary: Yes
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
Signature Title
Signature Date

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