FORM 1023-EZ for MIRROR MIRROR WELLNESS SPACE

Field Data
EIN 81-2147953
Case Number EO-2017114-000259
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MIRROR MIRROR WELLNESS SPACE
Organization’s Mailing Address 78 KOYEN STREET
City FORDS
State NJ
ZIP 08863
Accounting period End 12
Primary contact name KESHA WIGGS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KESHA WIGGS
EXECUTIVE DIRECTOR, CEO
78 KOYEN STREET
FORDS NJ 08863

Officer/Director/Trustee Two

CANDACE WIGGS
TRUSTEE
78 KOYEN STREET
FORDS NJ 08863

Officer/Director/Trustee Three

JARED WIGGS
TRUSTEE
68 VALE PLACE
SEWAREN NJ 07077

Officer/Director/Trustee Four

RONALD WIGGS
TRUSTEE
1461 ROUTE 88 WEST
BRICK NJ 08724

Officer/Director/Trustee Five

ANNISSA WHITE
TRUSTEE
529 WEST SCOTT AVENUE
RAHWAY NJ 07065

Organization’s website
Organization’s email MIRRORMIRROR2004@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/10/2017
Organization Incorporation State NJ
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 Yes
Donation of funds Yes
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 Yes
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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