FORM 1023-EZ for VILLAGE OF BARBOURSVILLE COMMUNITYWELLNESS COUNCIL INC

Field Data
EIN 81-2473485
Case Number EO-2016285-000296
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name VILLAGE OF BARBOURSVILLE COMMUNITYWELLNESS COUNCIL INC
Organization’s Mailing Address PO BOX 244
City BARBOURSVILLE
State WV
ZIP 25504
Accounting period End 12
Primary contact name TIFFANY TATUM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JENNIFER ANDERSON
PRESIDENT
6287 HIGHLAND DR
HUNTINGTON WV 25504

Officer/Director/Trustee Two

TIFFANY TATUM
VICE PRESIDENT
132 BRADY DR
BARBOURSVILLE WV 25504

Officer/Director/Trustee Three

ROBBIN ROSS
TREASURER
206 B PARK AVE
BARBOURSVILLE WV 25504

Officer/Director/Trustee Four

KERRY BART
SECRETARY
615 WATER STREET
BARBOURSVILLE WV 25504

Officer/Director/Trustee Five

CHRISTOPHER PRESTON
DIRECTOR
115 APPLEWOOD DRIVE
ONA WV 25545

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/2/2016
Organization Incorporation State WV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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