FORM 1023-EZ for COMMUNITY BIRTH AND WELLNESS CENTER

Field Data
EIN 47-5592021
Case Number EO-2016273-000424
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COMMUNITY BIRTH AND WELLNESS CENTER
Organization’s Mailing Address 8 CHURCH STREET
City FERGUSON
State MO
ZIP 63135
Accounting period End 10
Primary contact name EBONY MILLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRITTANY CAMPBELL
DIRECTOR
100 NORTH DADE
FERGUSON MO 63135

Officer/Director/Trustee Two

DENECIA HARRELL
CHAIR
3844 MCREE AVE
SAINT LOUIS MO 63110

Officer/Director/Trustee Three

CICELY PAYNE
CO-CHAIR
4561 FLAD APT 3W
SAINT LOUIS MO 63110

Officer/Director/Trustee Four

EBONY MILLER
FINANCIAL OFFICER
620 BUGLE RUN DRIVE
FLORISSANT MO 63034

Organization’s website WWW.CBWCSTL.ORG
Organization’s email INFO@CBWCSTL.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/26/2015
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E40 - Reproductive Health Care Facilities and Allied Services
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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