FORM 1023-EZ for I4031 HEALTH & WELLNESS ASSEMBLY INC

Field Data
EIN 86-1765232
Case Number EO-2021082-000267
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name I4031 HEALTH & WELLNESS ASSEMBLY INC
Organization’s Mailing Address 1839 BOLTON ST APT 1
City BALTIMORE
State MD
ZIP 21217
Accounting period End 1
Primary contact name ALEXANDRA FRANCOIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALEXANDRA FRANCOIS
CHIEF EXECUTIVE OFFICER
1839 BOLTON ST APT 1
BALTIMORE MD 21217

Officer/Director/Trustee Two

KANEKA BROWN
TRUSTEE
542 ADAMWOOD DR
NASHVILLE TN 37211

Officer/Director/Trustee Three

KIMBERLY THOMPSON
TRUSTEE
2 LAKE RIDGE PL APT K
COCKEYSVILLE MD 21030

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/29/2021
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N30 - Physical Fitness and Community Recreational Facilities
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
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 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 ALEXANDRA FRANCOIS
Signature Title CHIEF EXECUTIVE OFFICER
Signature Date 1/29/2021

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