FORM 1023-EZ for POWER ATHLETICS WELLNESS INC

Field Data
EIN 82-3075959
Case Number EO-2018043-000232
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name POWER ATHLETICS WELLNESS INC
Organization’s Mailing Address 3800 E MAIN ST STE A202
City SAINT CHARLES
State IL
ZIP 60174
Accounting period End 12
Primary contact name DAVID BROWN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID BROWN
PRESIDENT
3800 E MAIN ST STE A202
ST CHARLES IL 60174

Officer/Director/Trustee Two

MICHAEL BURNS
TREASUER
3800 E MAIN ST STE A202
ST CHARLES IL 60174

Officer/Director/Trustee Three

DAVIAN MITCHELL
VICE PRESIDENT
3800 E MAIN ST STE A202
ST CHARLES IL 60174

Officer/Director/Trustee Four

KAMAAL MCILWAIN
SECRETARY
3800 E MAIN ST STE A202
ST CHARLES IL 60174

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/9/17
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 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 DAVID BROWN
Signature Title PRESIDENT
Signature Date 2/8/18

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