FORM 1023-EZ for KATHLEENS ACADEMY FOR HEALTH AND WELL-BEING

Field Data
EIN 81-0942396
Case Number EO-2016109-000219
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KATHLEENS ACADEMY FOR HEALTH AND WELL-BEING
Organization’s Mailing Address 714 W 5TH STREET SUITE 120
City HASTINGS
State NE
ZIP 68901
Accounting period End 12
Primary contact name KATHLEEN BONNELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KATHLEEN BONNELL
PRESIDENT
80835 WALLACE CREEK AVE
SCOTIA NE 68875

Officer/Director/Trustee Two

MARVIN HUGHES
DIRECTOR
714 WEST 5TH SUITE 120
HASTINGS NE 68901

Officer/Director/Trustee Three

BOBBY SKYLER
DIRECTOR
714 WEST 5TH SUITE 120
HASTINGS NE 68901

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/29/2015
Organization Incorporation State NE
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: Yes
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
Signature Title
Signature Date

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