FORM 1023-EZ for THE WELL HOUSE

Field Data
EIN 81-3646147
Case Number EO-2016239-000180
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE WELL HOUSE
Organization’s Mailing Address 7935 US 60 EAST
City MOREHEAD
State KY
ZIP 40351
Accounting period End 8
Primary contact name KIMBERLY B DAVIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIMBERLY B DAVIS
ORGANIZER/AGENT/DIRECTOR
7935 US 60 EAST
MOREHEAD KY 40351

Officer/Director/Trustee Two

JOE DAVIS
DIRECTOR
7935 US 60 EAST
MOREHEAD KY 40351

Officer/Director/Trustee Three

NATHANIEL R DAVIS
DIRECTOR
39 CEDAR DRIVE
MOREHEAD KY 40351

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/24/2016
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F20 - Alcohol, Drug and Substance Abuse, Dependency Prevention and Treatment
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 Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
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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