FORM 1023-EZ for THREE-SIXTY HEALTH

Field Data
EIN 81-2900863
Case Number EO-2016166-000178
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THREE-SIXTY HEALTH
Organization’s Mailing Address 12765 NEW HALLS FERRY RD
City FLORISSANT
State MO
ZIP 63033
Accounting period End 12
Primary contact name ALICIA HUNTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ALICIA HUNTER
DIRECTOR
3830 RIVERSIDE POINTE DR
FLORISSANT MO 63034

Officer/Director/Trustee Two

SYVILLA GRIFFIN
OFFICER
258 ROYCE
ST. LOUIS MO 63135

Officer/Director/Trustee Three

REKINA HARROLD
SECRETARY
258 ROYCE
ST. LOUIS MO 63135

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/2016
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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