FORM 1023-EZ for OPTIMIZING HEALTH FOUNDATION

Field Data
EIN 83-3210020
Case Number EO-2019036-000569
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name OPTIMIZING HEALTH FOUNDATION
Organization’s Mailing Address 14067 MINT TRAIL
City SAN ANTONIO
State TX
ZIP 78232
Accounting period End 12
Primary contact name RENATA B FORD MD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RENATA FORD
DIRECTOR
14067 MINT TRAIL
SAN ANTONIO TX 78232

Officer/Director/Trustee Two

MICHAEL FORD
DIRECTOR
14067 MINT TRAIL
SAN ANTONIO TX 78232

Officer/Director/Trustee Three

CLIFF OLIVER
DIRECTOR
14067 MINT TRAIL
SAN ANTONIO TX 78232

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/18/19
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H43 - Heart, Circulatory Research
Organization’s purpose Charitable: No
Religious: No
Educational: No
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name RENATA FORD
Signature Title DIRECTOR
Signature Date 1/18/19

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