FORM 1023-EZ for NORTHEAST KANSAS CENTER FOR HEALTH AND WELLNESS INC

Field Data
EIN 48-0941952
Case Number EO-2017333-000435
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NORTHEAST KANSAS CENTER FOR HEALTH AND WELLNESS INC
Organization’s Mailing Address 240 W 18TH ST
City HORTON
State KS
ZIP 66439
Accounting period End 10
Primary contact name TOM KIDWELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVE THOMPSON
PRESIDENT
1583 280TH ST
HIAWATHA KS 66434

Officer/Director/Trustee Two

ED BERGER
VICE PRESIDENT
328 CHESTNUT ST
EVEREST KS 66424

Officer/Director/Trustee Three

THOMAS KIDWELL
TREASURER
1842 CIRCLE LN
HORTON KS 66439

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/3/1981
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E01 - Alliance/Advocacy Organizations
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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