FORM 1023-EZ for MEDICATION ENGAGEMENT REWARD INITIATIVE

Field Data
EIN 82-2115174
Case Number EO-2018197-000291
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MEDICATION ENGAGEMENT REWARD INITIATIVE
Organization’s Mailing Address 2274 WINTHROP CHASE DR
City CHARLOTTE
State NC
ZIP 28212
Accounting period End 12
Primary contact name ANTHONY NELSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANTHONY NELSON
DIRECTOR
2274 WINTHROP CHASE DR
CHARLOTTE NC 28212

Officer/Director/Trustee Two

GWYNDOLAN SWAIN
TRUSTEE
10400 SAM FURR RD
CHARLOTTE NC 28078

Organization’s website
Organization’s email NELSONQUESTHOLDINGS@ICLOUD.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/16/17
Organization Incorporation State NC
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: 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 ANTHONY NELSON
Signature Title DIRECTOR
Signature Date 7/12/18

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