FORM 1023-EZ for NAKA WELLNESS GROUP DBA HU SHIN KAI

Field Data
EIN 47-1474347
Case Number EO-2017248-000329
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NAKA WELLNESS GROUP DBA HU SHIN KAI
Organization’s Mailing Address 1920 CYPRESS LANE
City NORTHBROOK
State IL
ZIP 60062
Accounting period End 12
Primary contact name TOSHIHIDE NAKAMURA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TOSHIHIDE NAKAMURA
PRESIDENT AND DIRECTOR
1920 CYPRESS LANE
NORTHBROOK IL 60062

Officer/Director/Trustee Two

PRATIK DALAL
DIRECTOR
1515 S PRAIRIE AVE UNIT 1107
CHICAGO IL 60605

Officer/Director/Trustee Three

JAMES PAUL IRWIN
DIRECTOR
810 FOREST AVE UNIT 3E
EVANSTON IL 60202

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/27/2014
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N70 - Amateur Sports Competitions
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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