FORM 1023-EZ for HEALTHLINK COOPERATIVE

Field Data
EIN 83-3181388
Case Number EO-2019212-000272
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEALTHLINK COOPERATIVE
Organization’s Mailing Address 775 N UNIVERSITY AVE
City PROVO
State UT
ZIP 84601
Accounting period End 12
Primary contact name JEREMY A SKELTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEREMY SKELTON
DIRECTOR
3057 E HARMONY AVE
MESA AZ 85204-6307

Officer/Director/Trustee Two

CONNER ULRICH
PRESIDENT
3001 W DONAHUE DR
SIOUX FALLS SD 57105

Officer/Director/Trustee Three

JASMINE BANNER
DIRECTOR
PO BOX 23348
HONOLULU HI 96823

Officer/Director/Trustee Four

JUSTIN BOWMAN
DIRECTOR
3155 S HIDDEN VALLEY DR
ST GEORGE UT 84790

Officer/Director/Trustee Five

SUNNY YANG
OFFICER
743 N 900 E
PROVO UT 84604

Organization’s website WWW.HEALTHLINKCOOPERATIVE.ORG
Organization’s email HEALTHLINKCOOPERATIVE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/16/19
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P02 - Management & Technical Assistance
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 JEREMY SKELTON
Signature Title DIRECTOR
Signature Date 7/29/19

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