FORM 1023-EZ for VIRGINIA COMMUNITY HEALTH WORKER ASSOCIATION
| Field | Data |
|---|---|
| EIN | 83-3382939 |
| Case Number | EO-2020195-000143 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | VIRGINIA COMMUNITY HEALTH WORKER ASSOCIATION |
| Organization’s Mailing Address | 808 GRAYFOX DR |
| City | RICHMOND |
| State | VA |
| ZIP | 23223 |
| Accounting period End | 6 |
| Primary contact name | SHANTENY A JACKSON |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
SHANTENY JACKSON
PRESIDENT
808 GRAYFOX DR
RICHMOND VA 23223
Officer/Director/Trustee Two
STEPHANIE CARRINGTON
VICE-PRESIDENT
2211 HOLLY ST
RICHMOND VA 23223
Officer/Director/Trustee Three
SHERRELL THOMPSON
SECRETARY
400 E CARY ST
RICHMOND VA 23219
Officer/Director/Trustee Four
JENNIFER CANADA
TECHNOLOGY OFFICER
705 MAIN ST
DANVILLE VA 24541
| Organization’s website | CHWOFVA.COM |
|---|---|
| Organization’s email | INFO@CHWOFVA.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 6/4/2020 |
| Organization Incorporation State | VA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | Y03 - Professional Societies, Associations |
| 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 | No |
| Correctness Declaration | Yes |
| Signature Name | SHANTENY JACKSON |
| Signature Title | PRESIDENT |
| Signature Date | 6/7/2020 |
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