FORM 1023-EZ for LIGHT ON WELLNESS

Field Data
EIN 47-3390645
Case Number EO-2015128-000439
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIGHT ON WELLNESS
Organization’s Mailing Address 184 CHAMBERLIN STREET
City NASHVILLE
State TN
ZIP 37209-4812
Accounting period End 6
Primary contact name LAUREN MATTERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BRANDON BROWN
PRESIDENT
184 CHAMBERLIN STREET
NASHVILLE TN 37209-4812

Officer/Director/Trustee Two

HEATHER RINEY
VICE PRESIDENT
2320 WEST END AVE
NASHVILLE TN 37203

Officer/Director/Trustee Three

SAMANTHA MIOSI
SECRETARY/TREASURER
2003 CLUB PARKWAY
NASHVILLE TN 37221

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/12/2015
Organization Incorporation State TN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E80 - Health, General and Financing
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 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
Signature Title
Signature Date

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