FORM 1023-EZ for MISSION HEARTED FAMILY

Field Data
EIN 84-4423795
Case Number EO-2020057-000259
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MISSION HEARTED FAMILY
Organization’s Mailing Address 63 MILEY LOOP
City COLUMBUS
State MS
ZIP 39702
Accounting period End 12
Primary contact name STEPHANIE BURCH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STACY PETERSEN
EXECUTIVE DIRECTOR
63 MILEY LOOP
COLUMBUS MS 39702

Officer/Director/Trustee Two

LAUREN RHEA
TREASURER
3910 HIGHWAY 45 NORTH
COLUMBUS MS 39705

Officer/Director/Trustee Three

PATRICK HUGHES
CHAIRMAN OF THE BOARD
92 LITTLE CREEK LANE
COLUMBUS MS 39702

Officer/Director/Trustee Four

ERROLYN GRAY
VICE-CHAIRMAN OF THE BOARD
557 BARTON FERRY ROAD
WEST POINT MS 39783

Officer/Director/Trustee Five

STEPHANIE BURCH
SECRETARY
586 CROSBY LANE
COLUMBUS MS 39701

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/25/2019
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
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 Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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 STEPHANIE BURCH
Signature Title SECRETARY
Signature Date 2/24/2020

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