FORM 1023-EZ for ROBOTS WELLNESS INSTITUTE

Field Data
EIN 83-3413262
Case Number EO-2020216-000310
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ROBOTS WELLNESS INSTITUTE
Organization’s Mailing Address 2360 E CAMPUS DRIVE
City COTTONWOOD HEIGHTS
State UT
ZIP 84121
Accounting period End 12
Primary contact name JUSTIN MARTIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JUSTIN MARTIN
PRESIDENT DIRECTOR
2360 E CAMPUS DRIVE
COTTONWOOD HEIGHTS UT 84121

Officer/Director/Trustee Two

MARY LEE MARTIN
DIRECTOR
2360 E CAMPUS DRIVE
COTTONWOOD HEIGHTS UT 84121

Officer/Director/Trustee Three

DOLORES MARTIN
DIRECTOR
2360 E CAMPUS DRIVE
COTTONWOOD HEIGHTS UM 84121

Officer/Director/Trustee Four

LANCE ORLOB
DIRECTOR
207 SEQUIOA CIRCLE
ALPINE UT 84004

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/4/2019
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B05 - Research Institutes and/or Public Policy Analysis
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: Yes
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 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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JUSTIN MARTIN
Signature Title PRESIDENT DIRECTOR
Signature Date 7/30/2020

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