FORM 1023-EZ for JASPER COMMUNITY WELLNESS

Field Data
EIN 75-2783407
Case Number EO-2019234-000321
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JASPER COMMUNITY WELLNESS
Organization’s Mailing Address 301 WALNUT RUN ST
City JASPER
State TX
ZIP 75951
Accounting period End 9
Primary contact name WILLIE BROWN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WILLIE BROWN
DIRECTOR
301 WALNUT RUN ST
JASPER TX 75951

Officer/Director/Trustee Two

LARRY BROWN
DIRECTOR
301 WALNUT RUN ST
JASPER TX 75951

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/6/00
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G99 - Diseases, Disorders, Medical Disciplines N.E.C.
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name WILLIE BROWN
Signature Title DIRECTOR
Signature Date 8/20/19

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