FORM 1023-EZ for HEALTHY SYNERGY NONPROFIT CORPORATION

Field Data
EIN 46-0843331
Case Number EO-2015362-000163
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEALTHY SYNERGY NONPROFIT CORPORATION
Organization’s Mailing Address 20950 HAWTHORNE
City HARPER WOODS
State MI
ZIP 48225-1166
Accounting period End 12
Primary contact name MERICA PATTERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MERICA PATTERSON
PRESIDENT / FOUNDER
20950 HAWTHORNE
HARPER WOODS MI 48225-1166

Officer/Director/Trustee Two

CRYSTAL GRUNDY
TREASURER
20049 KEYSTONE
DETROIT MI 48234

Officer/Director/Trustee Three

LACEY BRADSHAW
DIRECTOR
5531 WOODHALL STREET
DETROIT MI 48224

Officer/Director/Trustee Four

SHAWNTE CASON
SECRETARY
14255 DELANO STREET
VAN NUYS CA 91401

Officer/Director/Trustee Five

DONNA WILLIS
DIRECTOR
16680 ARDMORE
DETROIT MI 48235

Organization’s website WWW.HEALTHYSYNERGY.ORG
Organization’s email MERICA@MERICAPATTERSON.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/21/2012
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 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
Signature Title
Signature Date

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