FORM 1023-EZ for SUNCREST FITNESS CENTER COMMUNITY HEALTH AND WELLNESS FOUNDATION

Field Data
EIN 83-2844615
Case Number EO-2019260-000198
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SUNCREST FITNESS CENTER COMMUNITY HEALTH AND WELLNESS FOUNDATION
Organization’s Mailing Address 6066 HIGHWAY 291
City NINE MILE FALLS
State WA
ZIP 99026
Accounting period End 12
Primary contact name JOEL SAN NICOLAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOEL SAN NICOLAS
PRESIDENT
PO BOX 549
NINE MILE FALLS WA 99026

Officer/Director/Trustee Two

MATTHEW FAIN
VICE PRESIDENT
2504 W HOUSTON AVE
SPOKANE WA 99208

Officer/Director/Trustee Three

JESSICA ROBERG
SECRETARY
6066 HIGHWAY 291
NINE MILE FALLS WA 99026

Officer/Director/Trustee Four

JOY BREESNEE
TREASURER
4124 E 29TH AVE
SPOKANE WA 99223

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/23/15
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N30 - Physical Fitness and Community Recreational Facilities
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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JOEL SAN NICOLAS
Signature Title PRESIDENT
Signature Date 9/15/19

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