FORM 1023-EZ for ADVANCED HEALTHCARE ALTERNATIVES CENTER FOR INTEGRATIVE MEDICINE AND

Field Data
EIN 81-2210678
Case Number EO-2016106-000156
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ADVANCED HEALTHCARE ALTERNATIVES CENTER FOR INTEGRATIVE MEDICINE AND
Organization’s Mailing Address 5404 MAIN ST
City NEW PORT RICHEY
State FL
ZIP 34652-2503
Accounting period End 12
Primary contact name SHARON MCREYNOLDS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SHARON MCREYNOLDS
P, S
5404 MAIN ST
NEW PORT RICHEY FL 34652-2503

Officer/Director/Trustee Two

JEFFREY MCREYNOLDS
VP
5404 MAIN ST
NEW PORT RICHEY FL 34652-2503

Officer/Director/Trustee Three

ELI KOLP
MED DIR
5404 MAIN ST
NEW PORT RICHEY FL 34652-2503

Officer/Director/Trustee Four

FAITH BEVAN
D
5404 MAIN ST
NEW PORT RICHEY FL 34652-2503

Organization’s website
Organization’s email ADVHEALTHCARE@HOTMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/9/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E30 - Health Treatment Facilities, Primarily Outpatient
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 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 No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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