FORM 1023-EZ for REPRIEVE CANCER AND DIALYSIS SPA

Field Data
EIN 83-1470683
Case Number EO-2019207-000278
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name REPRIEVE CANCER AND DIALYSIS SPA
Organization’s Mailing Address 4037 MCDONALD AVENUE
City ST LOUIS
State MO
ZIP 63116
Accounting period End 12
Primary contact name LINDA ORR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LINDA ORR
CO-OWNER
4037 MCDONALD AVENUE
ST LOUIS MO 63116-3818

Officer/Director/Trustee Two

MARIE FURMANSKI
CO-OWNER
4583 FOUNTAIN DRIVE
MARIETTA GA 30067-3657

Officer/Director/Trustee Three

REA WILLS
BOARD MEMBER
4037 MCDONALD AVENUE
ST LOUIS MO 63116-3818

Organization’s website
Organization’s email RBFL@ATT.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/24/18
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: No
Educational: No
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 LINDA ORR
Signature Title CO-OWNER
Signature Date 7/24/19

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