FORM 1023-EZ for TEMPLE HEALTH CONCEPTS

Field Data
EIN 86-3837804
Case Number EO-2021214-000199
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TEMPLE HEALTH CONCEPTS
Organization’s Mailing Address 430 E 162ND STREET UNIT 417
City SOUTH HOLLAND
State IL
ZIP 60473
Accounting period End 12
Primary contact name ELIZABETH BROWN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ELIZABETH BROWN
PRESIDENT
430 E 162ND STREET UNIT 417
SOUTH HOLLAND IL 60473

Officer/Director/Trustee Two

DAZELLE BURGESS
TREASURER
430 E 162ND STREET UNIT 417
SOUTH HOLLAND IL 60473

Officer/Director/Trustee Three

JEMIYA BOLDEN
SECRETARY
430 E 162ND STREET UNIT 417
SOUTH HOLLAND IL 60473

Organization’s website
Organization’s email TEMPLEHEALTHCONCEPTS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/16/2021
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
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 ELIZABETH BROWN
Signature Title PRESIDENT
Signature Date 7/29/2021

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