FORM 1023-EZ for SALUD Y VIDA COMMUNITY HEALTH WORKSHOPS

Field Data
EIN 81-1799578
Case Number EO-2016081-000184
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SALUD Y VIDA COMMUNITY HEALTH WORKSHOPS
Organization’s Mailing Address PO BOX 3106
City JACKSON
State WY
ZIP 83001-3106
Accounting period End 12
Primary contact name CORRIN BERG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CORRIN BERG
DIRECTOR
PO BOX 3082
JACKSON WY 83001-3082

Officer/Director/Trustee Two

TRAVERS SMITH
DIRECTOR
PO BOX 1785
WILSON WY 83014-1785

Organization’s website WWW.SALUDYVIDACOMMUNITYHEALTHWORKSHOPS.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/22/2016
Organization Incorporation State WY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion 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 Yes
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
Signature Title
Signature Date

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