FORM 1023-EZ for HEIS INC

Field Data
EIN 85-2431211
Case Number EO-2020237-000143
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEIS INC
Organization’s Mailing Address 4809 TROLLEY COURT
City ATLANTA
State GA
ZIP 30339
Accounting period End 12
Primary contact name WILLIAM GIVENS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WILLIAM GIVENS
DIRECTOR AND PRESIDENT
4809 TROLLEY COURT
ATLANTA GA 30339

Officer/Director/Trustee Two

ELIZABETH CORDY
DIRECTOR/VP/TREASURER
509 SUNSET LANE
EAST DUBLIN GA 31027

Officer/Director/Trustee Three

RON MASSEY
DIRECTOR AND SECRETARY
413 DOYLE AVE
REDLANDS CA 92374

Officer/Director/Trustee Four

SAM RAJ
DIRECTOR AND PARLIAMENTARIAN
2735 LIONS GATE DRIVE
CUMMING GA 30041

Officer/Director/Trustee Five

YANNICK BASABAKWINSHI
DIRECTOR
2359 ELLISON ROAD
CORNING NY 14830

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/14/2020
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
Educational: Yes
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 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 WILLIAM GIVENS
Signature Title DIRECTOR AND PRESIDENT
Signature Date 8/20/2020

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