FORM 1023-EZ for BREATH OF HEAVEN INC

Field Data
EIN 46-4617477
Case Number EO-2014287-000266
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BREATH OF HEAVEN INC
Organization’s Mailing Address PO BOX 523
City FORT MYERS
State FL
ZIP 33902
Accounting period End 12
Primary contact name WESLEY R CARTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHRISTOPHER RILEY
PRESIDENT
1509 PALM AVE B
FORT MYERS FL 33916

Officer/Director/Trustee Two

JESSICA RILEY
SECRETARY/TREASURER
1509 PALM AVE B
FORT MYERS FL 33916

Officer/Director/Trustee Three

VINCENT RUSSELLO
TRUSTEE
1228 NORTHWEST 26TH AVE
CAPE CORAL FL 33993

Officer/Director/Trustee Four

JESSICA LIBBY
TRUSTEE
4817 SW 8TH PLACE 202D
CAPE CORAL FL 33914

Officer/Director/Trustee Five

MICHAEL ROGERSON
TRUSTEE
16121 NORTH RIVER RD
ORLANDO FL 33920

Organization’s website WWW.CHRISANDJESSICARILEY.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/21/2014
Organization Incorporation State FL
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 Yes
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 Yes
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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