FORM 1023-EZ for HUMBLED HEARTS CHRISTIAN MINISTRY

Field Data
EIN 81-3623410
Case Number EO-2017123-000186
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HUMBLED HEARTS CHRISTIAN MINISTRY
Organization’s Mailing Address 420 N MAIN
City HARRISON
State AR
ZIP 72602
Accounting period End 12
Primary contact name TRISHA SISSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TRISHA SISSON
DIRECTOR
PO BOX 306
HARRISON AR 72601

Officer/Director/Trustee Two

MELISSA MELLENCAMP
DIRECTOR
420 N MAIN
HARRISON AR 72601

Officer/Director/Trustee Three

CHARLOTTE FONTENOT
SECRETARY
1614 SENIOR PKWY
HARRISON AR 72601

Officer/Director/Trustee Four

GARY HANNER
TREASURER
210 LINCOLN AVE
HARRISON AR 72601

Organization’s website WWW.HUMBLEDHEARTSCM.COM
Organization’s email HUMBLEDHEARTSCM@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/24/2016
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
Religious: Yes
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
Signature Title
Signature Date

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