FORM 1023-EZ for COMMUNITY PAIN AND WELLNESS INC

Field Data
EIN 83-1222493
Case Number EO-2018229-000142
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COMMUNITY PAIN AND WELLNESS INC
Organization’s Mailing Address 760 WEST LINCOLN HIGHWAY
City EXTON
State PA
ZIP 19341
Accounting period End 12
Primary contact name CARL E HILLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOSEPH R VERNA
PRESIDENT
21 CAMBERLY COURT
DOWNINGTOWN PA 19335

Officer/Director/Trustee Two

CARL E HILLER
DIRECTOR AND TREASURER/VICE PRESIDE
17 CAMBERLY COURT
DOWNINGTOWN PA 19335

Officer/Director/Trustee Three

SCOTT MASSEY
SECRETARY
1420 SHEEP BRIDGE ROAD
YORK PA 17406

Officer/Director/Trustee Four

PETER VINK
DIRECTOR
5 WATERFORD LANE
DOWNINGTOWN PA 19335

Officer/Director/Trustee Five

JOSEPH WALSH
DIRECTOR
847 CONNOR ROAD
WEST CHESTER PA 19380

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/11/18
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E50 - Rehabilitative Medical 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 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 CARL E HILLER
Signature Title DIRECTOR AND TREASURER/VICE PRESIDE
Signature Date 8/14/18

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