FORM 1023-EZ for HILLSIDE COMMUNITY WELLNESS CENTER

Field Data
EIN 84-3642572
Case Number EO-2019319-000111
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HILLSIDE COMMUNITY WELLNESS CENTER
Organization’s Mailing Address 219 NORTH 15TH AVENUE EAST
City DULUTH
State MN
ZIP 55805
Accounting period End 12
Primary contact name CHRISTINA M ANDERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GEIGER L YOUNT
DIRECTOR
3000 LONDON ROAD
DULUTH MN 55804

Officer/Director/Trustee Two

MARY ANN STARUS
DIRECTOR
3 LAKESIDE COURT
DULUTH MN 55804

Officer/Director/Trustee Three

CHRISTINA M ANDERSON
DIRECTOR
219 NORTH 15TH AVENUE EAST
DULUTH MN 55805

Officer/Director/Trustee Four

GREG GILBERT
DIRECTOR
2401 GREYSOLON ROAD
DULUTH MN 55812

Officer/Director/Trustee Five

SARAH BEEHLER
DIRECTOR
1714 EAST 4TH STREET APT H
DULUTH MN 55812

Organization’s website HEALTHINTHEHILLSIDE.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/11/19
Organization Incorporation State MN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support 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 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 CHRISTINA M ANDERSON
Signature Title DIRECTOR
Signature Date 11/13/19

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