FORM 1023-EZ for HEARTLITE INC

Field Data
EIN 83-1496599
Case Number EO-2018319-000098
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEARTLITE INC
Organization’s Mailing Address 602 WEST EDINGER AVENUE
City SANTA ANA
State CA
ZIP 92707
Accounting period End 12
Primary contact name WESLEY GEORGIEFF
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WESLEY GEORGIEFF
PRESIDENT
602 WEST EDINGER AVENUE
SANTA ANA CA 92707

Officer/Director/Trustee Two

DRANREB BARNUEVO
TREASURER
13732 ILLINOIS STREET
WESTMINSTER CA 92683

Officer/Director/Trustee Three

SANDRA ALVAREZ
SECRETARY
780 DURANZO STREET
CORONA CA 92882

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/8/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A12 - Fund Raising and/or Fund Distribution
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name WESLEY GEORGIEFF
Signature Title PRESIDENT
Signature Date 11/12/18

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