FORM 1023-EZ for EYES ON HEALTH AND WELLNESS INC

Field Data
EIN 82-2953151
Case Number EO-2018078-000573
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EYES ON HEALTH AND WELLNESS INC
Organization’s Mailing Address 3580 BROOKSTONE WAY
City UNION CITY
State GA
ZIP 30291
Accounting period End 12
Primary contact name ELAINE WIGGINS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ELAINE WIGGINS
PRESIDENT
3580 BROOKSTONE WAY
UNION CITY GA 30291

Officer/Director/Trustee Two

RICKEY WIGGINS
VICE-PRESIDENT
3580 BROOKSTONE WAY
UNION CITY GA 30291

Officer/Director/Trustee Three

KELLY STITT
TREASURER
3580 BROOKSTONE WAY
UNION CITY GA 30291

Officer/Director/Trustee Four

SUSAN HOLLY
BOARD MEMBER
15881 EVERGREEN ROAD
DETROIT MI 48223

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/14/17
Organization Incorporation State GA
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 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 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 ELAINE WIGGINS
Signature Title PRESIDENT
Signature Date 3/17/18

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