FORM 1023-EZ for RARE HEART CORP

Field Data
EIN 84-2939002
Case Number EO-2019252-000383
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RARE HEART CORP
Organization’s Mailing Address 907 SUGARBERRY DR
City HAHIRA
State GA
ZIP 31632-1939
Accounting period End 12
Primary contact name KELVIN MARTIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KELVIN MARTIN
PRESIDENT
907 SUGARBERRY DR
HAHIRA GA 31632-1939

Officer/Director/Trustee Two

DARCY WILLIAMS
SECRETARY
1429 YUCAIPA CIR
VALDOSTA GA 31601-2492

Officer/Director/Trustee Three

ZACHARY JAMARCO WARREN
VICE PRESIDENT
222 NORTH POINTE DR
GAINSVILLE GA 30501-7809

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/27/19
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O54 - Youth Development - Citizenship Programs
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 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 KELVIN MARTIN
Signature Title PRESIDENT
Signature Date 9/6/19

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