FORM 1023-EZ for PLAY HEART SMART

Field Data
EIN 84-3987343
Case Number EO-2020006-000633
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PLAY HEART SMART
Organization’s Mailing Address 9928 SHAHAN COURT
City INDIANAPOLIS
State IN
ZIP 46256
Accounting period End 12
Primary contact name ASHLEY WILLIAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ASHLEY WILLIAMS
PRESIDENT
9928 SHAHAN COURT
INDIANAPOLIS IN 46256

Officer/Director/Trustee Two

BEVERLY JONES
TREASURER
10506 E 79TH ST
INDIANAPOLIS IN 46236

Officer/Director/Trustee Three

ANDREA BEADLES
VICE PRESIDENT
7774 RIDGE RD
INDIANAPOLIS IN 46240

Officer/Director/Trustee Four

KIA JONES
SECRETARY
9936 SHAHAN CT
INDIANAPOLIS IN 46256

Organization’s website
Organization’s email PLAYHEARTSMART@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/16/2019
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support 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 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 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 ASHLEY WILLIAMS
Signature Title PRESIDENT
Signature Date 1/4/2020

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