FORM 1023-EZ for COMMUNITY WELLNESS FOUNDATION

Field Data
EIN 83-1754826
Case Number EO-2018273-000217
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COMMUNITY WELLNESS FOUNDATION
Organization’s Mailing Address 1301 N RICHARDSON AVE
City ROSWELL
State NM
ZIP 88201
Accounting period End 12
Primary contact name RICHARD GLENN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RICHARD GLENN
DIRECTOR/PRESIDENT
1301 N RICHARDSON AVE
ROSWELL NM 88201

Officer/Director/Trustee Two

JOSH NANNEN
DIRECTOR
1301 N RICHARDSON AVE
ROSWELL NM 88201

Officer/Director/Trustee Three

TABITHA DENNY
DIRECTOR
1301 N RICHARDSON AVE
ROSWELL NM 88201

Officer/Director/Trustee Four

MARK LEWIS
TREASURER
1301 N RICHARDSON AVE
ROSWELL NM 88201

Officer/Director/Trustee Five

MONICA GLENN
SECRETARY
1301 N RICHARDSON AVE
ROSWELL NM 88201

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/13/18
Organization Incorporation State NM
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: 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 RICHARD GLENN
Signature Title DIRECTOR/PRESIDENT
Signature Date 9/26/18

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