FORM 1023-EZ for A SINGLE HEART HELPING ONE

Field Data
EIN 86-3493228
Case Number EO-2021152-000903
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name A SINGLE HEART HELPING ONE
Organization’s Mailing Address 2928 SHARON DRIVE APT C
City KOKOMO
State IN
ZIP 46902
Accounting period End 12
Primary contact name SEANTA CONYERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SEANTA CONYERS
DIRECTOR
2928 SHARON DRIVE APT C
KOKOMO IN 46902

Officer/Director/Trustee Two

GARY BUSH
PRESIDENT
2928 SHARON DRIVE APT C
KOKOMO IN 46902

Officer/Director/Trustee Three

REBA HARRIS
VICE PRESIDENT
2928 SHARON DRIVE APT C
KOKOMO IN 46902

Officer/Director/Trustee Four

AMANDA GRANGER
SECRETARY
2928 SHARON DRIVE APT C
KOKOMO IN 46902

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/26/2021
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 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 SEANTA CONYERS
Signature Title DIRECTOR
Signature Date 5/31/2021

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