FORM 1023-EZ for MS-LOU HEALTH & WELLNESS

Field Data
EIN 84-3176692
Case Number EO-2019353-000288
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MS-LOU HEALTH & WELLNESS
Organization’s Mailing Address POST OFFICE BOX 1608
City WOODVILLE
State MS
ZIP 39669
Accounting period End 12
Primary contact name MARKETTA COLEMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARKETTA COLEMAN
PRESIDENT
38 FIG STREET
WOODVILLE MS 39669

Officer/Director/Trustee Two

TARWONNA WALKER
SECRETARY
448 JACKSON LANE
WOODVILLE MS 39669

Officer/Director/Trustee Three

DENISE TOLLIVER
TREASURER
POST OFFICE BOX 1533
WOODVILLE MS 39669

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/20/2019
Organization Incorporation State MS
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: 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 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 MARKETTA COLEMAN
Signature Title PRESIDENT
Signature Date 12/17/2019

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