FORM 1023-EZ for AMETHYST CENTER FOR HEALING INC
| Field | Data |
|---|---|
| EIN | 47-4611328 |
| Case Number | EO-2015343-000377 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | AMETHYST CENTER FOR HEALING INC |
| Organization’s Mailing Address | 1104 ASHTON AVENUE SUITE 212 |
| City | SALT LAKE CITY |
| State | UT |
| ZIP | 84106 |
| Accounting period End | 12 |
| Primary contact name | JANA FULMER |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
Officer/Director/Trustee One
JANA FULMER
EXECUTIVE DIRECTOR
2173 SOUTH NOWELL CIRCLE
SALT LAKE CITY UT 84115
Officer/Director/Trustee Two
MARTHA BURKETT-FALLIS
EXECUTIVE DIRECTOR
PO BOX 18042
KEARNS UT 84118
| Organization’s website | WWW.AMETHYSTCENTERFORHEALING.COM |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 6/26/2015 |
| Organization Incorporation State | UT |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | F32 - Community Mental Health Center |
| Organization’s purpose | Charitable: Yes Religious: No Educational: Yes Scientific: Yes Literary: No Public Safety: No Amateur Sports: No Cruelty Prevention: Yes |
| 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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