FORM 1023-EZ for FAIRYTALE PHYSICAL THERAPY INC

Field Data
EIN 83-2381729
Case Number EO-2021102-001005
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FAIRYTALE PHYSICAL THERAPY INC
Organization’s Mailing Address 203 CAPERTON ST
City PITTSBURGH
State PA
ZIP 15210
Accounting period End 12
Primary contact name JENNA KANTOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JENNA KANTOR
PRESIDENT
203 CAPERTON ST
PITTSBURGH PA 15210

Officer/Director/Trustee Two

KARI WILLETT
VICE PRESIDENT
8065 CRIMSON LEAF CT
GAINESVILLE VA 20155

Officer/Director/Trustee Three

NATE SAWYER
DIRECTOR
320 HAYWARD ST
MANCHESTER NH 03103

Organization’s website FAIRYTALEPHYSICALTHERAPY.COM
Organization’s email FAIRYTALE@FAIRYTALEPHYSICALTHERAPY.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/26/2020
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E86 - Patient Services - Entertainment, Recreation
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 Yes
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 KARI WILLETT
Signature Title VICE PRESIDENT
Signature Date 4/5/2021

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