FORM 1023-EZ for OPTIMAL WELL-BEING NETWORK INC
| Field | Data |
|---|---|
| EIN | 81-4065290 |
| Case Number | EO-2016285-000307 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | OPTIMAL WELL-BEING NETWORK INC |
| Organization’s Mailing Address | 10520 N PAYMENT PEAK RD |
| City | HAUSER |
| State | ID |
| ZIP | 83854 |
| Accounting period End | 12 |
| Primary contact name | NEILLY BUCKALEW |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
TIM FERRELL
BOARD DIRECTOR
2272 EAST JENALAN
POST FALLS ID 83854
Officer/Director/Trustee Two
DAVID LESONDAK
OFFICER
10 BALDWICK RD
PITTSBURGH PA 15205
Officer/Director/Trustee Three
TRACY PENNFIELD
OFFICER
PO BOX 251
CHELSEA VT 05038
Officer/Director/Trustee Four
NEILLY BUCKALEW
FOUNDING/PROGRAM DIRECTOR
10520 N PAYMENT PEAK RD
HAUSER ID 83854
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 9/26/2016 |
| Organization Incorporation State | ID |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E99 - Health - General and Rehabilitative N.E.C. |
| Organization’s purpose | Charitable: Yes Religious: No Educational: Yes Scientific: Yes 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 | Yes |
| 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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