FORM 1023-EZ for FOUNDATION FOR HEALTH SAFETY AND FITNESS

Field Data
EIN 81-3801142
Case Number EO-2016272-000345
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FOUNDATION FOR HEALTH SAFETY AND FITNESS
Organization’s Mailing Address 223 MAIN STREET SUITE C
City JONESBORO
State AR
ZIP 72401
Accounting period End 12
Primary contact name SONGA WHEELER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SONGA WHEELER
PRESIDENT AND CEO
223 MAIN STREET SUITE C
JONESBORO AR 72401

Officer/Director/Trustee Two

STEPHANIE STANK
VICE PRESIDENT
2302 LACOSTE DRIVE
JONESBORO AR 72404

Officer/Director/Trustee Three

ROBIN BANKS
SECRETARY
13960 RIDGEWOOD LANE
HARRISBURG AR 72432

Officer/Director/Trustee Four

LISA MOORE
TREASURER
2815 TOWERPARK
JONESBORO AR 72404

Organization’s website
Organization’s email SONGAWHEELER@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/8/2016
Organization Incorporation State AR
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: Yes
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
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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