FORM 1023-EZ for FITNESS WITH COMMUNITY 4 A BETTER LIFE

Field Data
EIN 84-3450741
Case Number EO-2019322-000497
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FITNESS WITH COMMUNITY 4 A BETTER LIFE
Organization’s Mailing Address 2741 NC HWY 58 SOUTH
City POLLOCKSVILLE
State NC
ZIP 28573
Accounting period End 12
Primary contact name ANGELA WILSON-WARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANGELA WILSON-WARD
EXECUTIVE DIRECTOR
2741 NC HWY 58 SOUTHQ
POLLOCKSVILLE NC 28573

Officer/Director/Trustee Two

DANIEL WARD
FOUNDER, BOARD CHAIR
2741 NC HWY 58 SOUTH
POLLOCKSVILLE

Officer/Director/Trustee Three

JULIET ROGERS
BOARD VICE PRESIDENT
4110 E MLK JR BLVD
NEW BERN NC 28562

Officer/Director/Trustee Four

SCOTT MURPHY
SECRETARY
4110 E MLK JR BLVD
NEW BERN NC 28562

Officer/Director/Trustee Five

SANDRA RUGER
TREASURER
4110 E MLK JR BLVD
NEW BERN NC 28562

Organization’s website
Organization’s email FITNESSWITHCOMMUNITY4ABETTERLIFE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/22/2019
Organization Incorporation State ND
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: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
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 ANGELA WILSON-WARD
Signature Title EXECUTIVE DIRECTOR
Signature Date 11/15/2019

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