FORM 1023-EZ for WASHINGTON WELLNESS PARK

Field Data
EIN 82-4429908
Case Number EO-2018051-000157
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WASHINGTON WELLNESS PARK
Organization’s Mailing Address 401 WESTVIEW CT
City WASHINGTON
State IA
ZIP 52353
Accounting period End 6
Primary contact name MARK KENDALL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LUKE HORAK
PRESIDENT
2735 W TRIO LANE
WASHINGTON IA 52353

Officer/Director/Trustee Two

CARL BROWN
VICE PRESIDENT
1095 235TH ST
KEOTA IA 52248

Officer/Director/Trustee Three

LARRY BARTLETT
SECRETARY
20 LOCUST LANE
WASHINGTON IA 52353

Officer/Director/Trustee Four

MARK KENDALL
TREASURER
401 WESTVIEW CT
WASHINGTON IA 52353

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/1/18
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N30 - Physical Fitness and Community Recreational Facilities
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 MARK KENDALL
Signature Title TREASURER
Signature Date 2/15/18

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