FORM 1023-EZ for RISE HEALTHY FOR LIFE

Field Data
EIN 84-3823114
Case Number EO-2020055-000446
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RISE HEALTHY FOR LIFE
Organization’s Mailing Address 227 E SULLIVAN ST
City KINGSPORT
State TN
ZIP 37660-4391
Accounting period End 12
Primary contact name CYNTHIA HUSS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CYNTHIA HUSS
MANAGING DIRECTOR
227 E SULLIVAN ST
KINGSPORT TN 37660-4391

Officer/Director/Trustee Two

WILLIAM POWELL
FINANCIAL DIRECTOR
227 E SULLIVAN ST
KINGSPORT TN 37660-4391

Officer/Director/Trustee Three

KHIA HUDGINS-SMITH
BOARD PRESIDENT
227 E SULLIVAN ST
KINGSPORT TN 37660-4391

Officer/Director/Trustee Four

PAEZHA MCCARTT
BOARD SECRETARY
227 E SULLIVAN ST
KINGSPORT TN 37660-4391

Officer/Director/Trustee Five

SARAH WHITE
CODIRECTOR
227 E SULLIVAN ST
KINGSPORT TN 37660-3491

Organization’s website WWW.RISEHFL.ORG
Organization’s email INFO@RISEHFL.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/21/2019
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B99 - Education N.E.C.
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence Yes
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 CYNTHIA HUSS
Signature Title MANAGING DIRECTOR
Signature Date 2/20/2020

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