FORM 1023-EZ for RESTORE OPTIMAL WELLNESS FOUNDATIONINC

Field Data
EIN 82-4845615
Case Number EO-2018089-000479
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RESTORE OPTIMAL WELLNESS FOUNDATIONINC
Organization’s Mailing Address 1728 E ARROYO SECO
City COTTONWOOD
State AZ
ZIP 86326
Accounting period End 3
Primary contact name REBECCA SMYDA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

REBECCA SMYDA
CEO
1728 E ARROYO SECO
COTTONWOOD AZ 86326

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/14/18
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
Organization’s purpose Charitable: Yes
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 No
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name REBECCA SMYDA
Signature Title CEO
Signature Date 3/28/18

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