FORM 1023-EZ for STREET WELLNESS INC

Field Data
EIN 82-1996787
Case Number EO-2017195-000195
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name STREET WELLNESS INC
Organization’s Mailing Address 239 W 520 N
City OREM
State UT
ZIP 84057-4696
Accounting period End 12
Primary contact name ASHLEIGH STREET
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ASHLEIGH STREET
DIRECTOR/PRESIDENT/CEO TREASURER
1075 E 100 N
PLEASANT GROVE UT 84062-2532

Officer/Director/Trustee Two

CARLA DEBOER
DIRECTOR AND SECRETARY
563 E 1840 N
OREM UT 84097-2226

Officer/Director/Trustee Three

SUZANNE CRABB
DIRECTOR
239 W 520 N
OREM UT 84057-4696

Organization’s website WWW.STREETWELLNESS.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/23/2017
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
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 Yes
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 Yes
One Third Support Gifts No
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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