FORM 1023-EZ for BROKEN HEART MINISTRIES INC

Field Data
EIN 26-2204237
Case Number EO-2018140-000151
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BROKEN HEART MINISTRIES INC
Organization’s Mailing Address 156 HIGH COLONY LANE
City THOMASVILLE
State GA
ZIP 31792
Accounting period End 12
Primary contact name EMMA HEDRINGTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EMMA HEDRINGTON
CHIEF EXECUTIVE OFFICER
156 HIGH COLONY LANE
THOMASVILLE GA 31792

Officer/Director/Trustee Two

CLARENCE HEDRINGTON
3RD VICE PRESIDENT
156 HIGH COLONY LANE
THOMAVILLE GA 31792

Officer/Director/Trustee Three

PRISCILLA MAXWELL
SECRETARY
509 GRADY STREET
THOMASVILLE GA 31792

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/22/08
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P62 - Victims' Services
Organization’s purpose Charitable: Yes
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 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 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 EMMA HEDRINGTON
Signature Title CHIEF EXECUTIVE OFFICER
Signature Date 5/15/18

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