FORM 1023-EZ for NEW MEXICO BLACK WELLNESS COALITION

Field Data
EIN 81-1334310
Case Number EO-2016104-000039
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NEW MEXICO BLACK WELLNESS COALITION
Organization’s Mailing Address 2320 KROGH COURT NW
City ALBUQUERQUE
State NM
ZIP 87104-2508
Accounting period End 6
Primary contact name TONYA COVINGTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARIO CRUZ
PRESIDENT
1718 ANDERSON PL SE
ALBUQUERQUE NM 87108-4406

Officer/Director/Trustee Two

TONYA COVINGTON
VICE PRESIDENT
2320 KROGH COURT NW
ALBUQUERQUE NM 87104-2508

Officer/Director/Trustee Three

STEPHANIE MCIVER
SECRETARY
908 TRUMAN NE
ALBUQUERQUE NM 87110-6450

Officer/Director/Trustee Four

ERIK WATSON
TREASURER
5623 UNIVERSITY BLVD
ALBUQUERQUE NM 87106-9701

Organization’s website
Organization’s email NMBLACHHEALTHGROUP@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/26/2016
Organization Incorporation State NM
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E01 - Alliance/Advocacy Organizations
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 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 Yes
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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