FORM 1023-EZ for REVOLUTION CHIROPRACTIC AND WELLNESS INC

Field Data
EIN 87-1737262
Case Number EO-2021214-000661
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name REVOLUTION CHIROPRACTIC AND WELLNESS INC
Organization’s Mailing Address 817 W WALNUT AVE
City DUNCAN
State OK
ZIP 73533
Accounting period End 12
Primary contact name BRAD MONTGOMERY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRAD MONTGOMERY
PRESIDENT DIRECTOR
817 W WALNUT AVE
DUNCAN OK 73533

Officer/Director/Trustee Two

JULIE MONTGOMERY
SECRETARY TREASURER
817 W WALNUT AVE
DUNCAN OK 73533

Officer/Director/Trustee Three

PHILLIP ARAGON
DIRECTOR
817 W WALNUT AVE
DUNCAN OK 73533

Officer/Director/Trustee Four

DEBORAH ARAGON
DIRECTOR
817 W WALNUT AVE
DUNCAN OK 73533

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/18/2021
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
Organization’s purpose Charitable: Yes
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 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 BRAD MONTGOMERY
Signature Title PRESIDENT DIRECTOR
Signature Date 7/30/2021

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