FORM 1023-EZ for HERITAGE CENTER FOOD PANTRY

Field Data
EIN 83-3197557
Case Number EO-2019092-000339
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HERITAGE CENTER FOOD PANTRY
Organization’s Mailing Address P O BOX 281
City ROSELAND
State VA
ZIP 22967
Accounting period End 12
Primary contact name DELORES GREEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DELORES GREEN
COORDINATOR
10 GILES LANE
ROSELAND VA 22967

Officer/Director/Trustee Two

FRANCES LEE
PRESIDENT
816 ROSE HILL DRIVE
CHARLOTTESVILLE VA 22903

Officer/Director/Trustee Three

SHARON HUDSON
VICE PRESIDENT
1032 STONY CREEK EAST
NELLYSFORD VA 22958

Officer/Director/Trustee Four

BETTY DILLARD
SECRETARY
158 LEVEL GREEN ROAD
ROSELAND VA 22967

Officer/Director/Trustee Five

PEGGY COOPER
TREASURER
110 MOUNTAIN VIEW LANE
ARRINGTON VA 22922

Organization’s website
Organization’s email HERITAGECENTERFOODPANTRY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/7/19
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K31 - Food Banks, Food Pantries
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 DELORES GREEN
Signature Title COORDINATOR
Signature Date 3/29/19

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