FORM 1023-EZ for HEALTHY KIDZ & TEENZ

Field Data
EIN 14-1854639
Case Number EO-2019336-000193
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEALTHY KIDZ & TEENZ
Organization’s Mailing Address PO BOX 92
City TIBURON
State CA
ZIP 94920
Accounting period End 12
Primary contact name ANARA DENNEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANARA DENNEN
EXECUTIVE DIRECTOR
PO BOX 92
TIBURON CA 94920

Officer/Director/Trustee Two

ELLA DENNEN
TRUSTEE
PO BOX 92
TIBURON CA 94920

Officer/Director/Trustee Three

CHARLES PERRY
OFFICER
PO BOX 92
TIBURON CA 94920

Organization’s website WWW.HKANDT.ORG
Organization’s email SUPPORT@HKANDT.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/1/02
Organization Incorporation State OR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support 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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ANARA DENNEN
Signature Title EXECUTIVE DIRECTOR
Signature Date 11/29/19

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