FORM 1023-EZ for LL WHOLESTIC HEALTH SERVICES

Field Data
EIN 46-1065582
Case Number EO-2016330-000268
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LL WHOLESTIC HEALTH SERVICES
Organization’s Mailing Address 4835 VALLEY ST
City ALEXANDRIA
State VA
ZIP 22312
Accounting period End 12
Primary contact name LISHAN KASSA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LISHAN KASSA
MEDICAL DIRECTOR
6226 CRESTWOOD DR
ALEXANDRIA VA 22312

Officer/Director/Trustee Two

TEFERA WENDEMU
PRESIDENT
2229 SHIRLINGTON RD
ARLINGTON VA 22206

Officer/Director/Trustee Three

LEMLEM TSEGAW
PEACE MAKING DIRECTOR
4726 GRAND MASTERS WAY
WOODBRIDGE VA 22192

Organization’s website WWW.LLWHS.ORG
Organization’s email LISHANMED@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/19/2012
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E50 - Rehabilitative Medical 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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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