FORM 1023-EZ for HEARTS FOR MINDS ADULT CARE INC

Field Data
EIN 81-1968724
Case Number EO-2016119-000318
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEARTS FOR MINDS ADULT CARE INC
Organization’s Mailing Address 9420 SW 34TH STREET
City MIAMI
State FL
ZIP 33165
Accounting period End 12
Primary contact name DELIA ROSA KENNEDY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BIBIANA LACORRA
FOUNDER PRESIDENT
9420 SW 34TH STREET
MIAMI FL 33165

Officer/Director/Trustee Two

ERNESTO MEDINA
VICE PRESIDENT
9420 SW 34 STREET
MIAMI FL 33165

Officer/Director/Trustee Three

MARIA GUARDA
SECRETARY
9420 SW 34 STREET
MIAMI FL 33165

Officer/Director/Trustee Four

YOLANDA VELIZ
TREASURER
9420 SW 34 STREET
MIAMI FL 33165

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/3/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P81 - Senior Centers, Services
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 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
Signature Title
Signature Date

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