FORM 1023-EZ for HEART 2 HEART COLLABORATIVE INC

Field Data
EIN 47-5190471
Case Number EO-2015275-000179
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEART 2 HEART COLLABORATIVE INC
Organization’s Mailing Address PO BOX 1494
City RALEIGH
State NC
ZIP 27602
Accounting period End 12
Primary contact name USHMA PATEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LARA HUSARY NACER
CO-CHAIR
9 GARDENVIEW PLACE
DURHAM NC 27713

Officer/Director/Trustee Two

MATTHEW STARR
CO-CHAIR
2308 FLORIDA CT
RALEIGH NC 27615

Officer/Director/Trustee Three

USHMA PATEL
TREASURER
1117 CHECKERBERRY DRIVE
MORRISVILLE NC 27560

Officer/Director/Trustee Four

JASON ALMEIDA
DATA MASTER
107 LOCKE WOODS RD
RALEIGH NC 27603

Officer/Director/Trustee Five

DENE ALMEIDA
PFAC LIAISON
107 LOCKE WOODS RD
RALEIGH NC 27603

Organization’s website WWW.NCHEARTS.ORG
Organization’s email INFO@NCHEARTS.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/3/2015
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G43 - Heart and Circulatory System Diseases, Disorders
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 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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