FORM 1023-EZ for THE AWAKENING WELLNESS CLINIC

Field Data
EIN 83-4500399
Case Number EO-2020268-000187
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE AWAKENING WELLNESS CLINIC
Organization’s Mailing Address 8 CARVER ROAD
City JACKSONVILLE
State NC
ZIP 28540-7010
Accounting period End 12
Primary contact name NICOLE BARNES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NICOLE BARNES
BOARD CHAIR
8 CARVER ROAD
JACKSONVILLE NC 28540-7010

Officer/Director/Trustee Two

AMY CICERON
SECRETARY
116 ROBINHOOD DRIVE
JACKSONVILLE NC 28546-5529

Officer/Director/Trustee Three

MICHAEL LEDDICK
VICE CHAIR
215 VALENCIA DRIVE APT 509
JACKSONVILLE NC 28546-7321

Officer/Director/Trustee Four

LAMAR FERRELL
TREASURER
6369 BRAY STREET
TARAWA TERRACE II NC 28543-1268

Organization’s website
Organization’s email AWAKENINGWC@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/3/2019
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F21 - Alcohol, Drug Abuse, Prevention Only
Organization’s purpose Charitable: Yes
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 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 NICOLE BARNES
Signature Title BOARD CHAIR
Signature Date 9/22/2020

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