FORM 1023-EZ for COMMUNITY WELLNESS FORUM

Field Data
EIN 47-4756204
Case Number EO-2018318-000015
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COMMUNITY WELLNESS FORUM
Organization’s Mailing Address 2615 E NEUTRA COURT
City ELK GROVE
State CA
ZIP 95758
Accounting period End 12
Primary contact name MARK MEEKS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARK MEEKS
CEO
2615 E NEUTRA COURT
ELK GROVE CA 95758

Officer/Director/Trustee Two

DONNA WINSTON
TREASURER
117 MILLER WAY
FOLSOM CA 95630

Officer/Director/Trustee Three

WILLIE MAE ROWE
OFFICER
1372 SEYMOUR CIRCLE
LINCOLN CA 95648

Officer/Director/Trustee Four

KIONNA ROWE
CHAIRPERSON
7219 SERTA COURT
ELK GROVE CA 95757

Officer/Director/Trustee Five

STEPHANIE THOMPSON
VICE CHAIRPERSON
64 HIDDEN LAKE CIRCLE
SACRAMENTO CA 95831

Organization’s website HTTP://THECOMMUNITYWELLNESSFORUM.ORG/
Organization’s email INFO@THECOMMUNITYWELLNESSFORUM.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/15/15
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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 No
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name WILLIE MAE ROWE
Signature Title OFFICER
Signature Date 11/5/18

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