FORM 1023-EZ for HEALING SPIRIT MEDICINE

Field Data
EIN 45-5006375
Case Number EO-2019135-000265
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEALING SPIRIT MEDICINE
Organization’s Mailing Address 1074 N SWAN
City TUCSON
State AZ
ZIP 85711
Accounting period End 6
Primary contact name JASMINE MAY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JASMINE MAY
CEO
4102 E CAMINO DE LA COLINA
TUCSON AZ 85711

Officer/Director/Trustee Two

CARMEN HOUK
COO
631 N ERIN AVE
TUCSON AZ 85711

Officer/Director/Trustee Three

ANGELA WOJTOWICZ
DIRECTOR
10436 E SIXTO MOLINO LN
TUCSON AZ 85747

Officer/Director/Trustee Four

MARTHA TODD
CHIEF FINANCIAL OFFICER
101 SABIN
KALAMAZOO MI 49006

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/11
Organization Incorporation State AZ
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: 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name JASMINE MAY
Signature Title CEO
Signature Date 5/13/19

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