FORM 1023-EZ for GIVE A HEADSTONE INC

Field Data
EIN 83-3644704
Case Number EO-2019053-000133
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GIVE A HEADSTONE INC
Organization’s Mailing Address 11469 260TH ST
City BLANCHARD
State OK
ZIP 73010
Accounting period End 12
Primary contact name ANDREA GREEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDREA GREEN
PRESIDENT
11469 260TH ST
BLANCHARD OK 73010

Officer/Director/Trustee Two

CRYSTAL WINES
TREASURER
13375 260TH ST
BLANCHARD OK 73010

Officer/Director/Trustee Three

AMBER BROWNING
SECRETARY
405 PERSSIMON COURT
BLANCHARD OK 73010

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/9/19
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P60 - Emergency Assistance (Food, Clothing, Cash)
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 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 ANDREA GREEN
Signature Title PRESIDENT
Signature Date 2/20/19

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