FORM 1023-EZ for DAPHNES HEART

Field Data
EIN 81-3094092
Case Number EO-2017124-000267
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DAPHNES HEART
Organization’s Mailing Address 831B WHITE CROSS ROAD
City CHAPEL HILL
State NC
ZIP 27516
Accounting period End 12
Primary contact name DAPHNE BELFIELD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAPHNE BELFIELD
PRESIDENT
831B WHITE CROSS ROAD
CHAPEL HILL NC 27516

Officer/Director/Trustee Two

SPENCER THOMPSON
SUPERVISOR
1130 LOUISIANA STREET
CLEWISTON DE 33440

Officer/Director/Trustee Three

MONROE THOMPSON
ASSISTANT SUPERVISOR
1130 LOUISIANA ST
CLEWISTON FL 33440

Officer/Director/Trustee Four

SHEILA ROBERTSON
DIRECTOR
509 NORTH FAYETTEVILLE STREET
CLAYTON NC 27520

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/22/2016
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L99 - Housing, Shelter N.E.C.
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 Yes
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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