FORM 1023-EZ for OMNI LIFE COMMUNITY HEALTH PARTNERSINC

Field Data
EIN 80-0469300
Case Number EO-2018250-000335
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name OMNI LIFE COMMUNITY HEALTH PARTNERSINC
Organization’s Mailing Address 11130 STRATFORD DR 417
City OKLAHOMA CITY
State OK
ZIP 73120
Accounting period End 12
Primary contact name TOMMY NASH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TOMMY NASH
BOARD DIRECTOR
11130 STRATFORD DR 417
OKLAHOMA CITY OK 77312

Officer/Director/Trustee Two

KATHERINE ROBINSON
SECRETARY TREASURER
1320 NE 54TH ST
OKLAHOMA CITY OK 73111

Officer/Director/Trustee Three

JOHNNIE REED
DIRECTOR
6014 N STONEWALL
OKLAHOMA CITY OK 73111

Officer/Director/Trustee Four

TINA NAFF
DIRECTOR
816 NE 17TH ST
OKLAHOMA CITY OK 73105

Officer/Director/Trustee Five

RICHARD PALMER
DIRECTOR
2300 N HOOD
OKLAHOMA CITY OK 73111

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/1/10
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E32 - Ambulatory Health Center, Community Clinic
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 Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TOMMY NASH
Signature Title FOUNDER
Signature Date 9/5/18

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