FORM 1023-EZ for HEALTHY&DWELL INC

Field Data
EIN 85-1062762
Case Number EO-2020196-000242
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEALTHY&DWELL INC
Organization’s Mailing Address 19299 GREEN VALLEY DR
City NOBLESVILLE
State IN
ZIP 46060
Accounting period End 12
Primary contact name RONDA OWENS-DEHMER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAN HOOVER
PRESIDENT
913 TULIP DR
PERU IN 46970

Officer/Director/Trustee Two

RONDA OWENS-DEHMER
BOARD MEMBER
19299 GREEN VALLEY DR
NOBLESVILLE IN 46060

Officer/Director/Trustee Three

PATRICIA NIKOLOV
SECRETARY
4108 PEARSON DR
WESTFIELD IN 46062

Officer/Director/Trustee Four

LINDSAY MANNING
BOARD MEMBER
3624 DAYLIGHT CT
INDIANAPOLIS IN 46227

Officer/Director/Trustee Five

SARA WEIDERHAFT
BOARD MEMBER
882 BURGESS HILL PASS
WESTFIELD IN 46074

Organization’s website
Organization’s email HEALTHYANDDWELL@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/15/2020
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L24 - Disability Housing
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 JAN HOOVER
Signature Title PRESIDENT
Signature Date 6/11/2020

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