FORM 1023-EZ for STONE MOUNTAIN HEMP FARM

Field Data
EIN 86-1933627
Case Number EO-2021096-001250
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name STONE MOUNTAIN HEMP FARM
Organization’s Mailing Address 23110 E WILLIAMS FIELD RD
City MESA
State AZ
ZIP 85212
Accounting period End 3
Primary contact name HEATHER N KEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID EBBERT
INCORPORATOR-PRESIDENT
23110 E WILLIAMS FIELD RD
MESA AZ 85212

Officer/Director/Trustee Two

ANTHONY RODRIGUEZ
INCORPORATOR-CHAIRPERSON
23110 E WILLIAMS FIELD RD
MESA AZ 85212

Officer/Director/Trustee Three

SHANTELL EBBERT
DIRECTOR-TREASURER
23110 E WILLIAMS FIELD RD
MESA AZ 85212

Officer/Director/Trustee Four

SHANA NUNEZ
SECRETARY
23110 E WILLIAMS FIELD RD
MESA AZ 85212

Officer/Director/Trustee Five

HEATHER KEY
OFFICER-STATUTORY AGENT
549 W KIVA AVE
MESA AZ 85210

Organization’s website N/A
Organization’s email STONEMOUNTAINHEMPFARMS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/9/2021
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H83 - Alzheimer's Disease Research
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: Yes
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 HEATHER KEY
Signature Title OFFICER-STATUTORY AGENT
Signature Date 3/11/2021
EIN 86-1933627
Case Number EO-2021096-001250
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name STONE MOUNTAIN HEMP FARM
Organization’s Mailing Address 23110 E WILLIAMS FIELD RD
City MESA
State AZ
ZIP 85212
Accounting period End 3
Primary contact name HEATHER N KEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID EBBERT
INCORPORATOR-PRESIDENT
23110 E WILLIAMS FIELD RD
MESA AZ 85212

Officer/Director/Trustee Two

ANTHONY RODRIGUEZ
INCORPORATOR-CHAIRPERSON
23110 E WILLIAMS FIELD RD
MESA AZ 85212

Officer/Director/Trustee Three

SHANTELL EBBERT
DIRECTOR-TREASURER
23110 E WILLIAMS FIELD RD
MESA AZ 85212

Officer/Director/Trustee Four

SHANA NUNEZ
SECRETARY
23110 E WILLIAMS FIELD RD
MESA AZ 85212

Officer/Director/Trustee Five

HEATHER KEY
OFFICER-STATUTORY AGENT
549 W KIVA AVE
MESA AZ 85210

Organization’s website N/A
Organization’s email STONEMOUNTAINHEMPFARMS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/9/2021
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H83 - Alzheimer's Disease Research
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: Yes
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 HEATHER KEY
Signature Title OFFICER-STATUTORY AGENT
Signature Date 3/11/2021

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