FORM 1023-EZ for TABIA KEONNA WOOLFORK RECREATIONALMENTAL HEALTH FITNESS FACILITY

Field Data
EIN 81-1908936
Case Number EO-2016088-000472
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TABIA KEONNA WOOLFORK RECREATIONALMENTAL HEALTH FITNESS FACILITY
Organization’s Mailing Address 6021 PORTSMOUTH CT
City MONTGOMERY
State AL
ZIP 36116
Accounting period End 12
Primary contact name PEGGIE HATTEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PEGGIE HATTEN
PRESIDENT, DIRECTOR
6021 PORTSMOUTH CT
MONTGOMERY AL 36116

Officer/Director/Trustee Two

TERRI JENKINS
SECRETARY, DIRECTOR
7185 ROUGH RD
MONTGOMERY AL 36116

Officer/Director/Trustee Three

CHARLIE JENKINS
TREASURER, DIRECTOR
7185 ROUGH RD
MONTGOMERY AL 36116

Officer/Director/Trustee Four

EUGENE WOOLFORK
DIRECTOR
160 COMANCHE ST APT 18
MONTEVALLO AL 35115

Officer/Director/Trustee Five

MARY HATTEN
VICE PRESIDENT, DIRECTOR
5728 PORTSMOUTH DRIVE
MONTGOMERY AL 36116

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/11/2016
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: Yes
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 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
Signature Title
Signature Date

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