FORM 1023-EZ for HEART INSTITUTE OF THE CARIBBEAN FOUNDATION INC

Field Data
EIN 47-4637721
Case Number EO-2015274-000429
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEART INSTITUTE OF THE CARIBBEAN FOUNDATION INC
Organization’s Mailing Address 3100 WEST END AVENUE STE 1275
City NASHVILLE
State TN
ZIP 37203
Accounting period End 12
Primary contact name MICHAEL O HOWARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DR ERNEST MADU
DIRECTOR
3100 WEST END AVE STE 1275
NASHVILLE TN 37203

Officer/Director/Trustee Two

DR BASIL WAINE KONG
PRESIDENT
3100 WEST END AVE STE 1275
NASHVILLE TN 37203

Officer/Director/Trustee Three

DR DAINIA BAUGH
DIRECTOR
3100 WEST END AVE STE 1275
NASHVILLE TN 37203

Officer/Director/Trustee Four

DR EDWIN TULLOCH REID
SECRETARY
3100 WEST END AVE STE 1275
NASHVILLE TN 37203

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/20/2015
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E11 - Single Organization Support
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 Yes
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
Signature Title
Signature Date

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