FORM 1023-EZ for HEALTH WITHIN

Field Data
EIN 37-1944426
Case Number EO-2019169-000467
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEALTH WITHIN
Organization’s Mailing Address 355 MID RIVERS MALL DR
City SAINT PETERS
State MO
ZIP 63376
Accounting period End 12
Primary contact name JESSICA HOFFMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JESSICA HOFFMAN
PRESIDENT/DIRECTOR
355 MID RIVERS MALL DR
SAINT PETERS MO 63376

Officer/Director/Trustee Two

COURTNEY SPIESS
DIRECTOR
355 MID RIVERS MALL DR
SAINT PETERS MO 63376

Officer/Director/Trustee Three

DANIEL ONEILL
DIRECTOR
355 MID RIVERS MALL DR
SAINT PETERS MO 63376

Officer/Director/Trustee Four

JUSTIN HOFFMAN
SECRETARY/TREASURER
355 MID RIVERS MALL DR
SAINT PETERS MO 63376

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/20/19
Organization Incorporation State MO
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: 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 JESSICA HOFFMAN
Signature Title PRESIDENT/DIRECTOR
Signature Date 6/14/19

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