FORM 1023-EZ for J & F MENTAL HEALTH & WELLBEING FOUNDATION

Field Data
EIN 82-2373265
Case Number EO-2019114-000424
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name J & F MENTAL HEALTH & WELLBEING FOUNDATION
Organization’s Mailing Address 10020 BALTIMORE NATIONAL PIKE 6100
City ELLICOTT CITY
State MD
ZIP 21042
Accounting period End 12
Primary contact name DAVE L DIXON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHNNY CHOWOE
EXECUTIVE DIRECTOR
707 MANCHESTER CIRCLE SOUTH
PICKERINGTON OH 43147

Officer/Director/Trustee Two

FAZZIE CHOWOE
ASSISTANCE EXECUTIVE DIRECTOR
707 MANCHESTER CIRCLE SOUTH
PICKERINGTON OH 43147

Officer/Director/Trustee Three

DAVE L DIXON
ACTING CFO
10013 OLD FREDERICK RD
ELLICOTT CITY MD 21042

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/7/17
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F32 - Community Mental Health Center
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 Yes
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 DAVE L DIXON
Signature Title ACTING CFO
Signature Date 4/22/19

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