FORM 1023-EZ for HEART SONG

Field Data
EIN 83-1179634
Case Number EO-2018291-000089
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEART SONG
Organization’s Mailing Address 8101 LA FON AVENUE
City LOUISVILLE
State KY
ZIP 40228
Accounting period End 12
Primary contact name LAURA PEREZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAURA PEREZ
PRESIDENT
8101 LA FON AVENUE
LOUISVILLE KY 40228

Officer/Director/Trustee Two

YEDITH RODRIGUEZ
VICE PRESIDENT
5405 BAYWOOD DRIVE
LOUISVILLE KY 40241

Officer/Director/Trustee Three

DEBORAH HOLT
SECRETARY
8101 LA FON AVENUE
LOUISVILLE KY 40228

Officer/Director/Trustee Four

JESSICA CRESSEY
TREASURER
6844 BARDSTOWN ROAD
LOUISVILLE KY 40291

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/14/18
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family Services
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 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 LAURA PEREZ
Signature Title PRESIDENT
Signature Date 10/16/18

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