FORM 1023-EZ for REVIVED HEARTS FOR JESUS INC

Field Data
EIN 85-1425083
Case Number EO-2021064-000540
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name REVIVED HEARTS FOR JESUS INC
Organization’s Mailing Address 204 A RIDGECREST LOOP
City MINNEOLA
State FM
ZIP 34715
Accounting period End 6
Primary contact name DIEGO QUIROZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DIEGO QUIROZ
DIRECTOR
204 A RIDGECREST LOOP
MINNEOLA FL 34715-5554

Officer/Director/Trustee Two

SHELLEY QUIROZ
DIRECTOR
204 A RIDGECREST LOOP
MINNEOLA FL 34715-5554

Officer/Director/Trustee Three

DANIEL CHALMERS
DIRECTOR
3901 NW 9TH AVE
MIAMI FL 33166-6508

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/15/2020
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
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 Yes
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 DIEGO QUIROZ
Signature Title DIRECTOR
Signature Date 1/4/2021

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