FORM 1023-EZ for CHAI 4 HEALTHY LIVING

Field Data
EIN 47-5656842
Case Number EO-2019269-000176
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHAI 4 HEALTHY LIVING
Organization’s Mailing Address 2043 EASTBURN AVE
City PHILADELPHIA
State PA
ZIP 19138
Accounting period End 12
Primary contact name ATIYA KEARNEY-LOFTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AMBROCIA MARTIN
VICE PRESIDENT
210 LEEDOM ST
WYNCOTE PA 19095

Officer/Director/Trustee Two

JAMES COLEY
TREASURER
8440 LIMEKILN PIKE
WYNCOTE PA 19095

Officer/Director/Trustee Three

TYNISHA HERDER-DUNCAN
SECRETARY
1835 WILLARD AVE
WILLOW GROVE PA 19001

Officer/Director/Trustee Four

ATIYA KEARNEY-LOFTON
PRESIDENT
2765 MIRIAM AVENUE
ABINGTON PA 19090

Officer/Director/Trustee Five

O 0
0
O
O PA 19001

Organization’s website CHAI4HEALTHYLIVING.COM
Organization’s email CHAI4HEALTHYLIVING@THERAPIST.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/10/16
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F32 - Community Mental Health Center
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 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 ATIYA KEARNEY-LOFTON
Signature Title PRESIDENT
Signature Date 9/24/19
EIN 47-5656842
Case Number EO-2016218-000184
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHAI 4 HEALTHY LIVING
Organization’s Mailing Address 2043 EASTBURN AVENUE
City PHILADELPHIA
State PA
ZIP 19138
Accounting period End 12
Primary contact name ATIYA MYERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ATIYA MYERS
PRESIDENT
2765 MIRIAM AVENUE
ABINGTON PA 19001

Officer/Director/Trustee Two

AMBROCIA CRAWFORD
VICE PRESIDENT
621 CROYDEN ROAD
CHELTENHAM PA 19012

Officer/Director/Trustee Three

TYNISHA DUNCAN-HERDER
SECRETARY
1835 WILLARD AVENUE
WILLOW GROVE PA 19001

Officer/Director/Trustee Four

ARICIA JOASIL
TREASURER
1720 PRINCETON AVE
LAWRENCE NJ 08648

Officer/Director/Trustee Five

JAMES COLEY JR
SECRETARY
8440 LIMEKILN PIKE APT3-813
WYNCOTE PA 19095

Organization’s website CHAI4HEALTHYLIVING.COM
Organization’s email CHAI4HEALTHYLIVING@THERAPIST.NET
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/23/2015
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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 No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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