FORM 1023-EZ for POTTERS HEART FOUNDATION
| Field | Data |
|---|---|
| EIN | 83-3672366 |
| Case Number | EO-2021116-000139 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | POTTERS HEART FOUNDATION |
| Organization’s Mailing Address | 3925 LAURELS FALLS DR |
| City | SNELLVILLE |
| State | GA |
| ZIP | 30039 |
| Accounting period End | 12 |
| Primary contact name | DIANE HODGE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
DIANE HODGE
CEO
3925 LAURELS FALLS DR
SNELLVILLE GA 30039
Officer/Director/Trustee Two
TYRONE HODGE
VICE PRESIDENT
32B INDEPENDENCE STREET
TARRYTOWN NY 10591
Officer/Director/Trustee Three
KEON REID
SECRETARY
554 ASHTON MANOR DR
LOGANVILLE GA 30052
Officer/Director/Trustee Four
DEBORAH SIMMOND-OMARIBA
CFO
3930 MOUNTAIN WAY COVE
SNELLVILLE GA 30039
Officer/Director/Trustee Five
PATRICIA NICHOLAS
PUBLIC RELATIONS OFFICER
3925 LAURELS FALLS DR
SNELLVILLE GA 30039
| Organization’s website | POTTERSHEARTFOUNDATION.ORG |
|---|---|
| Organization’s email | POTTERSHEARTFOUNDATION@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 2/22/2019 |
| Organization Incorporation State | GA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P73 - Group Home (Long Term) |
| 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 | 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 | DIANE HODGE |
| Signature Title | CEO |
| Signature Date | 4/22/2021 |
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