FORM 1023-EZ for PARTNERS IN WELLNESS

Field Data
EIN 27-0161179
Case Number EO-2015085-000605
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PARTNERS IN WELLNESS
Organization’s Mailing Address 331 WOMBLE RD
City SHELBYVILLE
State TN
ZIP 37160-6804
Accounting period End 12
Primary contact name JAMES E ELLIOTT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMES ELLIOTT
PRESIDENT
331 WOMBLE RD
SHELVYVILLE TN 37160-6804

Officer/Director/Trustee Two

SANDRA ZURI
SECRETARY
PO BOX 1385
SHELBYVILLE TN 37388-1385

Officer/Director/Trustee Three

JAMES WILSON
TREASURER
PO BOX 696
DUNN NC 28335

Organization’s website PARTNERSINWELLNESSTN.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/24/2006
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B99 - Education N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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