FORM 1023-EZ for HEART INC

Field Data
EIN 47-4956592
Case Number EO-2015344-000363
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEART INC
Organization’s Mailing Address 4955 PEONY LANE - ROOM C408
City PLYMOUTH
State MN
ZIP 55446
Accounting period End 12
Primary contact name BHARAT KUMAR PULGAM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BHARAT PULGAM
PRESIDENT DIRECTOR
6323 ZIRCON LANE N
MAPLE GROVE MN 55311

Officer/Director/Trustee Two

ZOE GORMLEY
TREASURER
930 FERNBROOK LANE N
PLYMOUTH MN 55447

Officer/Director/Trustee Three

JUDITH HANSON
DIRECTOR
1152 JACKSON AVENUE NE
ST MICHAEL MN 55376

Officer/Director/Trustee Four

JOEL OBERSTAR
DIRECTOR
9400 ZANE AVENUE
BROOKLYN PARK MN 55443

Officer/Director/Trustee Five

JENNIFER HOLPER
DIRECTOR
7779 48TH AVENUE N
NEW HOPE MN 55428

Organization’s website WWW.TEAMHEART.CO
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/1/2015
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: No
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 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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