FORM 1023-EZ for LOVEJUST COMMUNITY WELLNESS

Field Data
EIN 82-5324035
Case Number EO-2018141-000511
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LOVEJUST COMMUNITY WELLNESS
Organization’s Mailing Address 2718 TELEGRAPH AVE SUITE 210
City BERKELEY
State CA
ZIP 94705
Accounting period End 12
Primary contact name ARIEL PROVASOLI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ARIEL PROVASOLI
DIRECTOR AND PRESIDENT
4637 CONGRESS AVE APT C
OAKLAND CA 94601

Officer/Director/Trustee Two

CEPHUS JOHNSON
TREASURER
4637 CONGRESS AVE APT C
OAKLAND CA 94601

Officer/Director/Trustee Three

XIOMARA BATIN
DIRECTOR AND SECRETARY
124 PARKSIDE DR
BERKELEY CA 94705

Officer/Director/Trustee Four

CHERYL GRAHAM
DIRECTOR
1106 ESCALONA DR
SANTA CRUZ CA 95060

Officer/Director/Trustee Five

KRISTAN CASSADY
DIRECTOR
211 40TH STREET WAY APT 2
OAKLAND CA 94611

Organization’s website
Organization’s email LOVEJUSTCOMMUNITYWELLNESS.ORG@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/5/18
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E50 - Rehabilitative Medical 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 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 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 ARIEL PROVASOLI
Signature Title DIRECTOR AND PRESIDENT
Signature Date 5/18/18

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