FORM 1023-EZ for NOURISHED HEARTS

Field Data
EIN 47-1083696
Case Number EO-2016013-000371
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NOURISHED HEARTS
Organization’s Mailing Address 127 W 23RD ST
City HOLLAND
State MI
ZIP 49423-4708
Accounting period End 12
Primary contact name KIMBERLY A DE BLECOURT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KAREN BRINK
CHAIRWOMAN OF THE BOARD
3645 LINCOLN ROAD
HAMILTON MI 49419-9721

Officer/Director/Trustee Two

RONALD ANGER
VICE CHAIRMAN
9820 RAVINE RIDGE DR SE
CALEDONIA MI 49316-8235

Officer/Director/Trustee Three

LISA DUNLAP
TREASURER
2594 W CHESTER DR
ZEELAND MI 49464-9118

Officer/Director/Trustee Four

KATHY BRUINS
SECRETARY
16200 GREENLY ST
HOLLAND MI 49424-5851

Officer/Director/Trustee Five

THEODORE KOPPENAAL
TRUSTEE
429 RILEY ST
HOLLAND MI 49424-1705

Organization’s website NOURISHEDHEARTS.ORG
Organization’s email INFO@NOURISHEDHEARTS.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/12/2014
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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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