FORM 1023-EZ for WHITES WELLNESS CONSULTANTS INC

Field Data
EIN 82-3400953
Case Number EO-2017320-000437
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WHITES WELLNESS CONSULTANTS INC
Organization’s Mailing Address 128 CLAIBORNE STREET
City MADISON
State MS
ZIP 39110
Accounting period End 12
Primary contact name MONIQUE WHITE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MONIQUE WHITE
PRESIDENT/CEO
128 CLAIBORNE STREET
JACKSON MS 39206

Officer/Director/Trustee Two

CLIFTON ADDISON
VICE PRESIDENT
241 SPRINGWOOD DR
TERRY MS 39170

Officer/Director/Trustee Three

BRENDA JENKINS-CAMPBELL
TREASURER
8 AUTUMN COVE
JACKSON MS 39206

Officer/Director/Trustee Four

CHRISTINE MCINNIS
SECRETARY
6022 WOODHAVEN RD
JACKSON MS 39206

Organization’s website
Organization’s email WHITEWELLNESS1@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/4/2017
Organization Incorporation State MS
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 Yes
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
Signature Title
Signature Date

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