FORM 1023-EZ for HEALTH-E-GAMER FOUNDATION

Field Data
EIN 85-0533770
Case Number EO-2020106-000136
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEALTH-E-GAMER FOUNDATION
Organization’s Mailing Address 15610 BIBURY ALLEY
City UPPER MARLBORO
State MD
ZIP 20774
Accounting period End 4
Primary contact name MELITA MOORE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MELITA MOORE
CHIEF EXECUTIVE OFFICER
15610 BIBURY ALLEY
UPPER MARLBORO MD 20774

Organization’s website WWW.HEALTHEGAMER.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/23/2020
Organization Incorporation State MD
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 MELITA MOORE
Signature Title CHIEF EXECUTIVE OFFICER
Signature Date 4/13/2020

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