FORM 1023-EZ for CLARA JOS HEART INC

Field Data
EIN 86-1243124
Case Number EO-2021161-000171
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CLARA JOS HEART INC
Organization’s Mailing Address 825 FAIROAK AVE
City HYATTSVILLE
State MD
ZIP 20783
Accounting period End 12
Primary contact name ARNOLD WILLIAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CARLA BOWENS
PRESIDENT & CEO
825 FAIROAK AVE
HYATTSVILLE MD 20783

Officer/Director/Trustee Two

LATONYIA WADE
TREASURER & DIRECTOR
825 FAIROAK AVE
HYATTSVILLE MD 20783

Officer/Director/Trustee Three

KEISHA JACKSON
SECRETARY & DIRECTOR
825 FAIROAK AVE
HYATTSVILLE MD 20783

Officer/Director/Trustee Four

DEBRA CHAPLIN
DIRECTOR &VICEPRESIDENT
825 FAIROAK AVE
HYATTSVILLE MD 20783

Officer/Director/Trustee Five

ZENITTA ANDERSON
DIRECTOR
825 FAIROAK AVE
HYATTSVILLE MD 20783

Organization’s website
Organization’s email BOWENSCLIENTELE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/3/2020
Organization Incorporation State DC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 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 CARLA BOWENS
Signature Title PRESIDENT & CEO
Signature Date 6/8/2021

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