FORM 1023-EZ for HEALING ROOMS CHARLOTTESVILLE

Field Data
EIN 47-5057251
Case Number EO-2016043-000005
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEALING ROOMS CHARLOTTESVILLE
Organization’s Mailing Address 3511 MARLBORO COURT
City CHARLOTTESVILLE
State VA
ZIP 22901
Accounting period End 12
Primary contact name SUSAN STOUFFER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SUSAN STOUFFER
PRESIDENT/DIRECTOR
3511 MARLBORO COURT
CHARLOTTESVILLE VA 22901

Officer/Director/Trustee Two

ROBERT FRENCH
TREASURER/DIRECTOR
357 WINDIGROVE DRIVE NO 914
WAYNESBORO VA 22980

Officer/Director/Trustee Three

TERRY LEHMANN
SECRETARY/DIRECTOR
1700 OLD FORGE ROAD
CHARLOTTESVILLE VA 22901

Officer/Director/Trustee Four

JOCELYNN HELMBRECHT
DIRECTOR
430 FOXDALE LANE
CHARLOTTESVILLE VA 22901

Officer/Director/Trustee Five

CARL SCHONE
DIRECTOR
3365 EAGLES NEST PT
VIRGINIA BEACH VA 23452

Organization’s website WWW.HEALINGROOMSCHARLOTTESVILLE.COM
Organization’s email BOUNTIFULFAVOR@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/3/2015
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
Religious: Yes
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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