FORM 1023-EZ for FIGHT4WELLNESS

Field Data
EIN 84-4487851
Case Number EO-2020057-000241
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FIGHT4WELLNESS
Organization’s Mailing Address PO BOX 36928
City GROSSE POINTE
State MI
ZIP 48230
Accounting period End 12
Primary contact name SAMUEL E NUXOLL ESQ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DANIEL AMENT
PRESIDENT
PO BOX 36928
GROSSE POINTE MI 48230

Officer/Director/Trustee Two

TRICIA MORROW-GROUSTRA
SECRETARY
PO BOX 36928
GROSSE POINTE MI 48230

Officer/Director/Trustee Three

JAIME RAE TURNBULL
TREASURER
PO BOX 36928
GROSSE POINTE MI 48230

Officer/Director/Trustee Four

SAMUEL NUXOLL
AUTHORIZED REPRESENTATIVE
101 N MAIN ST 7TH FLOOR
ANN ARBOR MI 48104

Organization’s website WWW.FIGHT4WELLNESS.COM
Organization’s email FIGHT4WELLNESSOFFICIAL@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/28/2020
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
Organization’s purpose Charitable: Yes
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 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 SAMUEL NUXOLL
Signature Title AUTHORIZED REPRESENTATIVE
Signature Date 2/24/2020

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