FORM 1023-EZ for GRAND VALLEY HEALING GARDEN INC

Field Data
EIN 83-3918356
Case Number EO-2019073-000421
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GRAND VALLEY HEALING GARDEN INC
Organization’s Mailing Address 18267 LITTLE PARK ROAD
City GLADE PARK
State CO
ZIP 81523-8736
Accounting period End 12
Primary contact name TOM KAPER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ILEEN WHITE
EXECUTIVE DIRECTOR
18267 LITTLE PARK ROAD
GLADE PARK CO 81523-8736

Officer/Director/Trustee Two

PEG WOOD
DIRECTOR
6790 REEDER MESA ROAD
WHITEWATER CO 81527-9507

Officer/Director/Trustee Three

DENISE PAYNE
DIRECTOR
2564 SOUTH CORRAL DRIVE
GRAND JUNCTION CO 81505-9559

Officer/Director/Trustee Four

LISA RIEBEL
DIRECTOR
212 SUNSET DRIVE
FRUITA CO 81521-9549

Officer/Director/Trustee Five

TOM KAPER
DIRECTOR
2135 NORTH 7TH STREET
GRAND JUNCTION CO 81501-7421

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/9/19
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
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 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 TOM KAPER
Signature Title DIRECTOR
Signature Date 3/12/19

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