FORM 1023-EZ for HEALTHY SPINES INITIATIVE OF BAY COUNTY INC

Field Data
EIN 36-4903123
Case Number EO-2019036-000109
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEALTHY SPINES INITIATIVE OF BAY COUNTY INC
Organization’s Mailing Address 1705 RHODE ISLAND AVENUE
City LYNN HAVEN
State FL
ZIP 32444
Accounting period End 12
Primary contact name AMY BELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AMY BELL
PRESIDENT/DIRECTOR
1705 RHODE ISLAND AVENUE
LYNN HAVEN FL 32444

Officer/Director/Trustee Two

JESSICA FULCHER
TREASURER/DIRECTOR
1705 RHODE ISLAND AVENUE
LYNN HAVEN FL 32444

Officer/Director/Trustee Three

ASHLEY SAVAGE
SECRETARY/DIRECTOR
1705 RHODE ISLAND AVENUE
LYNN HAVEN FL 32444

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/3/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: No
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 AMY BELL
Signature Title PRESIDENT/DIRECTOR
Signature Date 1/16/19

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