FORM 1023-EZ for FAMILY WELLNESS NETWORK CLE INC

Field Data
EIN 47-3209674
Case Number EO-2015098-000282
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FAMILY WELLNESS NETWORK CLE INC
Organization’s Mailing Address 5247 WILSON MILLS RD SUITE 163
City RICHMOND HTS
State OH
ZIP 44143-6402
Accounting period End 12
Primary contact name SHIRLEY TATUM-CHAPMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SHIRLEY TATUM-CHAPMAN
DIRECTOR
345 KNOLLWOOD TRAIL
RICHMOND HTS OH 44143-1473

Officer/Director/Trustee Two

JACQUELINE TUCKER
DIRECTOR
354 ROYAL OAK BLVD
RICHMOND HTS OH 44143-1710

Officer/Director/Trustee Three

WARREN GROCE
DIRECTOR
12706 MAPLEROW AVE
GARFIELD HTS OH 44105-6916

Officer/Director/Trustee Four

DEBRA GROCE
PRESIDENT
12706 MAPLEROW AVE
GARFIELD HTS OH 44105-6916

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/14/2015
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: No
Literary: Yes
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 Yes
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
Signature Title
Signature Date

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