FORM 1023-EZ for ARTFULLY HEALED INC

Field Data
EIN 83-4067284
Case Number EO-2020134-000290
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ARTFULLY HEALED INC
Organization’s Mailing Address 4009 CORNING PLACE STE E2 347
City CHARLOTTE
State NC
ZIP 28216
Accounting period End 12
Primary contact name KIMBLYN HARRIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIMBLYN HARRIS
CHIEF EXECUTIVE OFFICER
6909
CHARLOTTE NC 28216

Officer/Director/Trustee Two

KAREN KAPLAN
VICE PRESIDENT
5623 SWANSTON DR
CHARLOTTE NC 28269

Officer/Director/Trustee Three

DORLEY SPELLER
TREASURER
8435 BLUE ASTER LN
CHARLOTTE NC 28269

Officer/Director/Trustee Four

NENA BARRETT
EXECUTIVE DIRECTOR
6909 KARNAK COURT
CHARLOTTE NC 28216

Officer/Director/Trustee Five

CHRISTIAN GREEN
SECRETARY
6909 KARNAK CT
CHARLOTTE NC 28216

Organization’s website WWW.ARTFULLYHEALED.ORG
Organization’s email INFO@ARTFULLYHEALED.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/30/2019
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 KIMBLYN HARRIS
Signature Title CHIEF EXECUTIVE OFFICER
Signature Date 5/11/2020

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