FORM 1023-EZ for WELLNESS STATION

Field Data
EIN 47-2732991
Case Number EO-2019238-000419
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WELLNESS STATION
Organization’s Mailing Address 5714 CIMARRON
City LOS ANGELES
State CA
ZIP 90062
Accounting period End 6
Primary contact name CAROLYNN MARTIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CAROLYNN MARTIN
EXECUTIVE DIRECTOR
5714
LOS ANGELES CA 90062

Officer/Director/Trustee Two

DONNA THOMAS
SECRETARY
5416 LONG BEACH AVENUE
LA CA 90058

Officer/Director/Trustee Three

RICHARD HAMILTON
VICE CHAIR
2808 CRENSHAW BLVD APT 503
LOS ANGELES CA 90018

Organization’s website WWW.WELLNESSLA.ORG
Organization’s email MARTIN4EAGLE@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/14/14
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code V01 - Alliance/Advocacy Organizations
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 CAROLYNN MARTIN
Signature Title EXECUTIVE DIRECTOR
Signature Date 8/22/19

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