FORM 1023-EZ for PANACEA CENTER FOR WELLNESS INC

Field Data
EIN 83-3065503
Case Number EO-2019113-000085
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PANACEA CENTER FOR WELLNESS INC
Organization’s Mailing Address 59 WASHINGTON STREET 177
City SANTA CLARA
State CA
ZIP 95050
Accounting period End 12
Primary contact name JACOB GRALNIK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JACOB GRALNIK
EXECUTIVE DIRECTOR
59 WASHINGTON STREET 177
SANTA CLARA CA 95050

Officer/Director/Trustee Two

ALIA KHIDIATOVA
PRESIDENT
4487 HOLLOW GATE LINE
SAN JOSE CA 95134

Officer/Director/Trustee Three

IRINA LASKORUNSKY
SECRETARY
4487 HOLLOW GATE LINE
SAN JOSE CA 95134

Officer/Director/Trustee Four

NATALIYA GALKINA
TREASURER
6439 MCABEE ROAD
SAN JOSE CA 95120

Officer/Director/Trustee Five

VADIM KRAKOVSKY
ASTROLOGER CONSULTANT
1028 HOWARD STREET APP 406
SAN FRANCISCO CA 94103

Organization’s website WWW.PANACEACENTERFORWELLNESS.ORG
Organization’s email LIFEFOODONWHEELS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/19/19
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K40 - Nutrition Programs
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 Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
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 JACOB GRALNIK
Signature Title EXECUTIVE DIRECTOR
Signature Date 4/21/19

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