FORM 1023-EZ for MOVE AND GROOVE FOR HEALTH

Field Data
EIN 81-2585253
Case Number EO-2016315-000303
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MOVE AND GROOVE FOR HEALTH
Organization’s Mailing Address 14910 PERRIS BLVD STE B172
City PERRIS
State CA
ZIP 92555
Accounting period End 12
Primary contact name TAMI DRAYTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TAMI DRAYTON
CHIEF OPERATIONS OFFICER
27110 OAK RIDGE DRIVE
MORENO VALLEY CA 92555

Officer/Director/Trustee Two

CLARENCE CLAY DRAYTON
CHIEF EXECUTIVE OFFICER
27110 OAK RIDGE DRIVE
MORENO VALLEY CA 92555

Officer/Director/Trustee Three

ELEANOR GRAY
CHIEF INFORMATION OFFICER
24249 ATWOOD AVE UNIT 114
MORENO VALLEY CA 92553

Officer/Director/Trustee Four

JOYCELYN RAMOS DIMERIC
CHIEF FINANCE OFFICER
27805 VIA SONATA
MORENO VALLEY CA 92555

Organization’s website WWW.MOVEANDGROOVE4HEALTH.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/22/2016
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N30 - Physical Fitness and Community Recreational Facilities
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 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
Signature Title
Signature Date

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