FORM 1023-EZ for HEAL CHARLOTTE

Field Data
EIN 81-5158164
Case Number EO-2017101-000078
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEAL CHARLOTTE
Organization’s Mailing Address 326 ORCHARD TRACE LANE APT 6
City CHARLOTTE
State NC
ZIP 28213
Accounting period End 12
Primary contact name GREG JACKSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANTUAN SMITH
CO-DIRECTOR
326 ORCHARD TRACE LANE APT 6
CHARLOTTE NC 28213

Officer/Director/Trustee Two

TAMMY BAILEY
SECRETARY
326 ORCHARD TRACE LANE APT 6
CHARLOTTE NC 28213

Officer/Director/Trustee Three

JEFF PREPTIT
TREASURE
326 ORCHARD TRACE LANE APT 6
CHARLOTTE NC 28213

Officer/Director/Trustee Four

GREGORY HAKIM JACKSON II
EXECUTIVE DICRECTOR
326 ORCHARD TRACE LANE APT 6
CHARLOTTE NC 28213

Organization’s website
Organization’s email ONEPEACEONEMIND@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/30/2017
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
Public Safety: Yes
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 Yes
One Third Support Gifts No
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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