FORM 1023-EZ for INSTITUTE OF NUTRITIONAL MEDICINE
| Field | Data |
|---|---|
| EIN | 84-5131948 |
| Case Number | EO-2020101-000063 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | INSTITUTE OF NUTRITIONAL MEDICINE |
| Organization’s Mailing Address | 10600 HIGHLAND SPRINGS AVE |
| City | CHERRY VALLEY |
| State | CA |
| ZIP | 92223 |
| Accounting period End | 12 |
| Primary contact name | DANA BODEK |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
JAN KIELMANN
CHIEF EXECUTIVE OFFICER/CHAIRMAN
10600 HIGHLAND SPRINGS AVENUE
CHERRY VALLEY CA 92223
Officer/Director/Trustee Two
DANNIELLE JASCOT
CHIEF FINANCIAL OFFICER/TREASURER
31 STABLE LANE
MIDDLETOWN CT 06457
Officer/Director/Trustee Three
DANA BODEK
CHIEF ADMINISTRATIVE OFFICER/SECRET
1903 WENTWORTH COURT
PITTSBURGH PA 15237
Officer/Director/Trustee Four
KENRESE CARTER
CHIEF COMMUNICATIONS OFFICER/VP
146 BELL RICHARD AVENUE
FORT POLK LA 71459
Officer/Director/Trustee Five
ANN MUSICK
CHIEF DEVELOPMENT OFFICER/ VP
8202 RHINE WAY
CENTERVILLE OH 45458
| Organization’s website | WWW.INSTITUTEFORNUTRITIONALMEDICINE.ORG |
|---|---|
| Organization’s email | INSTITUTENUTRITIONALMEDICINE@GMAIL.COM |
| Organization Incorporated | No |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 3/19/2020 |
| Organization Incorporation State | CA |
| 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 | 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 | DANA BODEK |
| Signature Title | CHIEF ADMINISTRATIVE OFFICER/SECRET |
| Signature Date | 4/8/2020 |
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