FORM 1023-EZ for HEALTH TO GROW ON

Field Data
EIN 47-1283399
Case Number EO-2014295-000103
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HEALTH TO GROW ON
Organization’s Mailing Address 2907 GRAYSBY AVE
City SAN PEDRO
State CA
ZIP 90732-4607
Accounting period End 12
Primary contact name SCOTT PERRY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SCOTT PERRY
CHIEF EXECUTIVE OFFICER
2807 GRAYSBY AVE
SAN PEDRO CA 90732-4607

Officer/Director/Trustee Two

VINCENT DAY
CHAIRPERSON
4433 OLMSTEAD RD
NEW ALBANY OH 43054

Officer/Director/Trustee Three

CHRISTOPHER PERRY
TREASURER
4 ROXBURY LA
WILTON CT 06897

Officer/Director/Trustee Four

DEBBIE IWAMOTO
OFFICER
1588 SOMBRER0 DR
MONTEREY PARK CA 91754

Officer/Director/Trustee Five

THEO NELSON
OFFICER
2807 GRAYSBY AVE
SAN PEDRO CA 90732-4607

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/7/2014
Organization Incorporation State CA
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 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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