FORM 1023-EZ for WOMENS HEALTH INITIATIVE NETWORK INC

Field Data
EIN 82-3828299
Case Number EO-2018164-000131
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WOMENS HEALTH INITIATIVE NETWORK INC
Organization’s Mailing Address 1715 INDIAN WOOD CIR STE 100
City MAUMEE
State OH
ZIP 43537
Accounting period End 12
Primary contact name KEVIN M GILMORE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDREW CROAK
PRESIDENT
1715 INDIAN WOOD CIR STE 100
MAUMEE OH 43537

Officer/Director/Trustee Two

NANCY ARQUETTE
VICE PRESIDENT
1715 INDIAN WOOD CIR STE 100
MAUMEE OH 43537

Officer/Director/Trustee Three

PETER KOLTZ
TREASURER
1715 INDIAN WOOD CIR STE 100
MAUMEE OH 43537

Officer/Director/Trustee Four

SARATH PALAKODETI
SECRETARY
1715 INDIAN WOOD CIR STE 100
MAUMEE OH 43537

Officer/Director/Trustee Five

BETH WHITE
TRUSTEE
1715 INDIAN WOOD CIR STE 100
MAUMEE OH 43537

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/27/17
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 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 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 ANDREW CROAK
Signature Title PRESIDENT
Signature Date 6/11/18

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