FORM 1023-EZ for HEALTH X HOLLYWOOD

Field Data
EIN 83-3996691
Case Number EO-2019353-000357
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEALTH X HOLLYWOOD
Organization’s Mailing Address 3705 W PICO BLVD 1598
City LOS ANGELES
State CA
ZIP 90019
Accounting period End 12
Primary contact name LAUREN SENKBEIL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAUREN SENKBEIL
BOARD MEMBER/PRESIDENT
425 N OAKHURST DR 205
BEVERLY HILLS CA 90210

Officer/Director/Trustee Two

DENISE LEE
BOARD MEMBER/TREASURER
2916 GALESHEAD DR
UPPER MARLBORO MD 20772

Officer/Director/Trustee Three

DEANNE ROWE
BOARD MEMBER/SECRETARY
9517 MANOR OAKS VIEW
UPPER MARLBORO MD 20772

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/5/2019
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: No
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 LAUREN SENKBEIL
Signature Title BOARD MEMBER/PRESIDENT
Signature Date 12/17/2019

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