FORM 1023-EZ for THE HEALING STATIONS INC

Field Data
EIN 47-5097763
Case Number EO-2016347-000032
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE HEALING STATIONS INC
Organization’s Mailing Address 4662 WEBSTER WAY NW
City ACWORTH
State GA
ZIP 30101
Accounting period End 12
Primary contact name GENEVA VANDERHORST
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PHYLLIS AILES
CHIEF EXECUTIVE OFFICER
4662 WEBSTER WAY NW
ACWORTH GA 30101

Officer/Director/Trustee Two

LORRAINE MARTIN
CHAIRPERSON
1002 KNIGHTSBRIGE ROAD
KENNESAW GA 30144

Officer/Director/Trustee Three

KELLY HEMPHILL
TREASURER
800 WATERFORD ESTATE MANOR
CANTON GA 30115

Officer/Director/Trustee Four

JEANNETTE THOMAS
SECRETARY
1100 EXECUTIVE LANE APT E
KENNESAW GA 30144

Officer/Director/Trustee Five

BRUCE BROOKS
VICE CHAIR
522 RIVERWOOD DR
DALLAS GA 30157

Organization’s website NA
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/21/2015
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family 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
Signature Title
Signature Date

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