FORM 1023-EZ for MY HEART YOUR HEART

Field Data
EIN 47-3479414
Case Number EO-2015251-000448
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MY HEART YOUR HEART
Organization’s Mailing Address 1500 E MED CTR DR SPC 5853 CVC 2367
City ANN ARBOR
State MI
ZIP 48109-5853
Accounting period End 12
Primary contact name THOMAS CRAWFORD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

THOMAS CRAWFORD
DIRECTOR - PRESIDENT
1500 E MED CTR DR SPC 5853 CVC 2367
ANN ARBOR MI 48109-5853

Officer/Director/Trustee Two

KIM EAGLE
DIRECTOR - TREASURER
1500 E MED CTR DR SPC 5853 CVC 2367
ANN ARBOR MI 48109-5853

Officer/Director/Trustee Three

SHELDON DAVIS
DIRECTOR
1500 E MED CTR DR SPC 5853 CVC 2367
ANN ARBOR MI 48109-5853

Officer/Director/Trustee Four

GEORGE SAMSON
DIRECTOR
1500 E MED CTR DR SPC 5853 CVC 2367
ANN ARBOR MI 48109-5853

Officer/Director/Trustee Five

KARMAN TANDON
DIRECTOR - SECRETARY
1500 E MED CTR DR SPC 5853 CVC 2367
ANN ARBOR MI 48109-5853

Organization’s website
Organization’s email KARMANTANDON@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/18/2015
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Q33 - International Relief
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 Yes
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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