FORM 1023-EZ for HEADS UP HELP FOUNDATION

Field Data
EIN 81-2879424
Case Number EO-2016165-000338
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEADS UP HELP FOUNDATION
Organization’s Mailing Address PO BOX 2036
City BENTONVILLE
State AR
ZIP 72712
Accounting period End 12
Primary contact name SCOTT STRATTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROBERT WILLIAMS
DIRECTOR
PO BOX 2036
BENTONVILLE AR 72712

Officer/Director/Trustee Two

ALEX KILGO
DIRECTOR
PO BOX 2036
BENTONVILLE AR 72712

Officer/Director/Trustee Three

SHERRIE EVERETT
DIRECTOR
708 NORTH 1890 WEST
PROVO UT 84601

Organization’s website HTTPS://HEADSUPHELP.ORG/
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/12/2016
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F80 - Mental Health Association, Multipurpose
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 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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