FORM 1023-EZ for WELLNESS INSTITUTE AT NUTRITION THERAPY RX INC

Field Data
EIN 47-2781854
Case Number EO-2015026-000211
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WELLNESS INSTITUTE AT NUTRITION THERAPY RX INC
Organization’s Mailing Address 4530 OLDE PERIMETER WAY SUITE 110
City ATLANTA
State GA
ZIP 30346
Accounting period End 12
Primary contact name NORMA J CURBY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

NORMA J CURBY
PRESIDENT
4530 OLDE PERIMETER WAY SUITE 110
ATLANTA GA 30346

Officer/Director/Trustee Two

RAYMOND CURBY
CFO
1100 JOHNSON FERRY RD SUITE 250C
MARIETTA GA 30068

Officer/Director/Trustee Three

BRITTANY CURBY
SECRETARY
250 PHARR RD SUITE 1613
ATLANTA GA 30305

Officer/Director/Trustee Four

JMICHAEL GRIFFIN
DIRECTOR
1981 FLINT HILL DRIVE
LAWRENCEVILLE GA 30044

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/13/2015
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F80 - Mental Health Association, Multipurpose
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 No
Benefit of College Yes
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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