FORM 1023-EZ for TEAM WESLEY FITNESS & WELLNESS

Field Data
EIN 83-3516218
Case Number EO-2019050-000387
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TEAM WESLEY FITNESS & WELLNESS
Organization’s Mailing Address 1228 BARKLEY DRIVE
City BATON ROUGE
State LA
ZIP 70810
Accounting period End 12
Primary contact name DERRICK WESLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DERRICK WESLEY
DIRECTOR
1228 BARKLEY DRIVE
BATON ROUGE LA 70810

Officer/Director/Trustee Two

JUSTIN DAWKINS
MEMBER
5652 SHALLOW RUN APT 410
BENBROOK TX 76109

Officer/Director/Trustee Three

DEMECIA DAWKINS
MEMBER
12903 BRANT ROCK DR APT 702
HOUSTON TX 77082

Officer/Director/Trustee Four

SHAWANN WATSON
MEMBER
1331 JEFFERSON STREET
GRETNA LA 70053

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/15/19
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O52 - Youth Development - Agricultural
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 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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DERRICK WESLEY
Signature Title DIRECTOR
Signature Date 2/15/19

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