FORM 1023-EZ for REVIVE WELLNESS CENTER INC

Field Data
EIN 84-1932330
Case Number EO-2019213-000098
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name REVIVE WELLNESS CENTER INC
Organization’s Mailing Address 44148 W BUCKHORN TRAIL
City MARICOPA
State AZ
ZIP 85138
Accounting period End 12
Primary contact name WENDY MILLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EVANGELINE POSWAL
PRESIDENT
44148 W BUCKHORN TRAIL
MARICOPA AZ 85138

Officer/Director/Trustee Two

CHRISTINE LUKE
SECRETARY
44148 W BUCKHORN TRAIL
MARICOPA AZ 85138

Officer/Director/Trustee Three

MEKISHA CARTER
TREASURER
44148 W BUCKHORN TRAIL
MARICOPA AZ 85138

Officer/Director/Trustee Four

WINNETKA MILLER
DIRECTOR
44148 W BUCKHORN TRAIL
MARICOPA AZ 85138

Organization’s website
Organization’s email INFO@REVIVEWELLNESSCENTER.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/17/19
Organization Incorporation State AZ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 No
Donation of funds Yes
Conducting Activities Outside of United States Yes
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 EVANGELINE POSWAL
Signature Title PRESIDENT
Signature Date 7/30/19

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