FORM 1023-EZ for COLORADO VETERANS HEALTH AND WELLNESS AGENCY

Field Data
EIN 81-2950640
Case Number EO-2016169-000199
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COLORADO VETERANS HEALTH AND WELLNESS AGENCY
Organization’s Mailing Address 1330 QUAIL LAKE LOOP SUITE 260
City COLORADO SPRINGS
State CO
ZIP 80906
Accounting period End 12
Primary contact name DR CHARLES WEBER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHARLES WEBER
EXECUTIVE DIRECTOR
1330 QUAIL LAKE LOOP SUITE 260
COLORADO SPRINGS CO 80906

Officer/Director/Trustee Two

RAE ANN WEBER
CHAIRMAN
1330 QUAIL LAKE LOOP SUITE 260
COLORADO SPRINGS CO 80906

Officer/Director/Trustee Three

DUANE FRANCE
CHIEF ADMINISTRATIVE OFFICE
1330 QUAIL LAKE LOOP SUITE 260
COLORADO SPRINGS CO 80906

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/15/2016
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F30 - Mental Health Treatment - Multipurpose and N.E.C.
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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
Signature Title
Signature Date

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