FORM 1023-EZ for HEALTH AND WEALTH ADULT DAY SERVICES INC

Field Data
EIN 82-2912182
Case Number EO-2017303-000331
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEALTH AND WEALTH ADULT DAY SERVICES INC
Organization’s Mailing Address 137B TWIN HILL ROAD
City AUSTELL
State GA
ZIP 30168-7724
Accounting period End 12
Primary contact name FRANKIE TARVER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

FRANKIE TARVER
CHAIRMAN
137B TWIN HILL ROAD
AUSTELL GA 30168-7724

Officer/Director/Trustee Two

NIKIA SILER
SECRETARY
85 TREVERS LAKE DRIVE
COVINGTON GA 30016-1995

Officer/Director/Trustee Three

SAMANTHA BROWN HIGHTOWER
TREASURER
7801 PROVIDENCE POINT WAY
LITHONIA GA 30058-5171

Organization’s website
Organization’s email FRANKTARVER@ATT.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/3/2017
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 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 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
Signature Title
Signature Date

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