WELLNESSWORX INC: Form 990, tax year 2021

View the entire original 990 at ProPublica ↗

Organization
WELLNESSWORX INC (EIN 83-2689231)
Tax period
2021-01-01 to 2021-12-31
Filed
2022-11-15
IRS object ID
202223199349326922
Schema version
2021v4.2
Source
Download XML · Original 990 at ProPublica

Every field in the e-filed return. Faint text is the IRS element name, for citing.

Return header ReturnHeader

FieldValueIRS element (for citing)
Return2022-11-15T17:09:54-06:00ReturnTs
Tax Period End2021-12-31TaxPeriodEndDt

Preparer Firm PreparerFirmGrp

FieldValueIRS element (for citing)
Preparer Firm EIN953680171PreparerFirmEIN

Preparer Firm Name PreparerFirmName

FieldValueIRS element (for citing)
Business Name Line1MCGOWAN GUNTERMANNBusinessNameLine1Txt

Preparer US Address PreparerUSAddress

FieldValueIRS element (for citing)
Address Line1200 E CARRILLO STREET SUITE 300AddressLine1Txt
CitySANTA BARBARACityNm
State AbbreviationCAStateAbbreviationCd
ZIP931017141ZIPCd
FieldValueIRS element (for citing)
Return Type990ReturnTypeCd
Tax Period Begin2021-01-01TaxPeriodBeginDt

Filer Filer

FieldValueIRS element (for citing)
EIN832689231EIN

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1WELLNESS WORX INCBusinessNameLine1Txt
FieldValueIRS element (for citing)
Business Name ControlWELLBusinessNameControlTxt
Phone8055481637PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11901 S VICTORIA AVENUE SUITE 109AddressLine1Txt
CityOXNARDCityNm
State AbbreviationCAStateAbbreviationCd
ZIP93035ZIPCd

Business Officer BusinessOfficerGrp

FieldValueIRS element (for citing)
PersonJOHN ZABASKYPersonNm
Person TitlePRESIDENTPersonTitleTxt
Phone8005481637PhoneNum
Signature2022-11-15SignatureDt
Discuss With Paid PreparerYes (1)DiscussWithPaidPreparerInd

Signing Officer SigningOfficerGrp

Person Full Name PersonFullName

FieldValueIRS element (for citing)
Person FirstJOHNPersonFirstNm
Person LastZABASKYPersonLastNm
FieldValueIRS element (for citing)
SSN999009999SSN

Preparer Person PreparerPersonGrp

FieldValueIRS element (for citing)
Preparer PersonCHRISLEY N REED CPAPreparerPersonNm
PTINP00025230PTIN
Phone8059629175PhoneNum

Additional Filer Information AdditionalFilerInformation

Trusted Customer TrustedCustomerGrp

FieldValueIRS element (for citing)
Trusted Customer3TrustedCustomerCd
Authentication Assurance LevelAAL1AuthenticationAssuranceLevelCd
Identity Assurance LevelIAL1IdentityAssuranceLevelCd
FieldValueIRS element (for citing)
Tax2021TaxYr
Build TS2022-09-23 18:48:47ZBuildTS

Form 990 IRS990

Doing Business As Name DoingBusinessAsName

FieldValueIRS element (for citing)
Business Name Line1XTENSION HEALTHBusinessNameLine1Txt
FieldValueIRS element (for citing)
Principal OfficerJOHN ZABASKYPrincipalOfficerNm

US Address USAddress

FieldValueIRS element (for citing)
Address Line11901 S VICTOIRA AVE STE 109AddressLine1Txt
CityOXNARDCityNm
State AbbreviationCAStateAbbreviationCd
ZIP93035ZIPCd
FieldValueIRS element (for citing)
Gross Receipts$38,223,719GrossReceiptsAmt
Group Return For Affiliates0GroupReturnForAffiliatesInd
Organization501c3Yes (X)Organization501c3Ind
Website AddressWWW.XTENSIONHEALTH.COMWebsiteAddressTxt
Type Of Organization CorpYes (X)TypeOfOrganizationCorpInd
Formation2017FormationYr
Legal Domicile StateCALegalDomicileStateCd
Activity Or MissionTO PROVIDE SUBSIDIZED HEALTH AND WELLNESS SERVICES TO LOW INCOME WORKERS.ActivityOrMissionDesc
Voting Members Governing Body3VotingMembersGoverningBodyCnt
Voting Members Independent0VotingMembersIndependentCnt
Total Employee0TotalEmployeeCnt
Total Volunteers5TotalVolunteersCnt
Total Gross UBI$0TotalGrossUBIAmt
Net Unrelated Bus Txbl Incm$0NetUnrelatedBusTxblIncmAmt
PY Contributions Grants$5,000PYContributionsGrantsAmt
CY Contributions Grants$0CYContributionsGrantsAmt
PY Program Service Revenue$21,437,258PYProgramServiceRevenueAmt
CY Program Service Revenue$38,223,703CYProgramServiceRevenueAmt
PY Investment Income$0PYInvestmentIncomeAmt
CY Investment Income$16CYInvestmentIncomeAmt
PY Other Revenue$0PYOtherRevenueAmt
CY Other Revenue$0CYOtherRevenueAmt
PY Total Revenue$21,442,258PYTotalRevenueAmt
CY Total Revenue$38,223,719CYTotalRevenueAmt
PY Grants And Similar Paid$21,394,760PYGrantsAndSimilarPaidAmt
CY Grants And Similar Paid$38,140,435CYGrantsAndSimilarPaidAmt
PY Benefits Paid To Members$0PYBenefitsPaidToMembersAmt
CY Benefits Paid To Members$0CYBenefitsPaidToMembersAmt
PY Salaries Comp Emp Bnft Paid$0PYSalariesCompEmpBnftPaidAmt
CY Salaries Comp Emp Bnft Paid$0CYSalariesCompEmpBnftPaidAmt
PY Total Prof Fndrsng Expns$0PYTotalProfFndrsngExpnsAmt
CY Total Prof Fndrsng Expns$0CYTotalProfFndrsngExpnsAmt
CY Total Fundraising Expense$0CYTotalFundraisingExpenseAmt
PY Other Expenses$45,303PYOtherExpensesAmt
CY Other Expenses$78,025CYOtherExpensesAmt
PY Total Expenses$21,440,063PYTotalExpensesAmt
CY Total Expenses$38,218,460CYTotalExpensesAmt
PY Revenues Less Expenses$2,195PYRevenuesLessExpensesAmt
CY Revenues Less Expenses$5,259CYRevenuesLessExpensesAmt
Total Assets BOY$4,560TotalAssetsBOYAmt
Total Assets EOY$109,819TotalAssetsEOYAmt
Total Liabilities BOY$11,000TotalLiabilitiesBOYAmt
Total Liabilities EOY$111,000TotalLiabilitiesEOYAmt
Net Assets Or Fund Balances BOY-$6,440NetAssetsOrFundBalancesBOYAmt
Net Assets Or Fund Balances EOY-$1,181NetAssetsOrFundBalancesEOYAmt
Info In Schedule O Part IIIYes (X)InfoInScheduleOPartIIIInd
MissionWE PROVIDE SUBSIDIZED HEALTHCARE AND WELLNESS SERVICES TO LOW INCOME EMPLOYEES. THIS INCLUDES HEALTH RISK ASSESSMENTS TO GATHER THE MEDICAL DATA NEEDED FOR OUR STAFF TO CREATE PERSONALIZED CHRONIC CONDITION MANAGEMENT PROGRAMS. THOSE PROGRAMS HELP EMPLOYEES TO ABATE THEIR CHRONIC CONDITIONS BY CHANGING PHYSICAL AND BEHAVIORAL PATTERNS. WE ALSO SUBSIDIZE TELEHEALTH VISITS FOR THIS SAME CHARITABLE CLASS.MissionDesc
Significant New Program Srvc0SignificantNewProgramSrvcInd
Significant Change0SignificantChangeInd
Expense$38,189,935ExpenseAmt
Grant$38,140,435GrantAmt
Revenue$38,223,703RevenueAmt
DescSUCCESSFULLY PROVIDED GRANTS TO THOUSANDS OF LOW INCOME EMPLOYEES OVER $38 MILLION DOLLARS.Desc
Total Program Service Expenses$38,189,935TotalProgramServiceExpensesAmt
Described In Section501c3Yes (1)DescribedInSection501c3Ind
Schedule B Required0ScheduleBRequiredInd
Political Campaign Acty0PoliticalCampaignActyInd
Lobbying Activities0LobbyingActivitiesInd
Subject To Proxy Tax0SubjectToProxyTaxInd
Donor Advised Fund0DonorAdvisedFundInd
Conservation Easements0ConservationEasementsInd
Collections Of Art0CollectionsOfArtInd
Credit Counseling0CreditCounselingInd
Donor Rstr Or Quasi Endowments0DonorRstrOrQuasiEndowmentsInd
Report Land Building EquipmentYes (1)ReportLandBuildingEquipmentInd
Report Investments Other Sec0ReportInvestmentsOtherSecInd
Report Program Related Invst0ReportProgramRelatedInvstInd
Report Other Assets0ReportOtherAssetsInd
Report Other Liabilities0ReportOtherLiabilitiesInd
Include FIN48 FootnoteYes (1)IncludeFIN48FootnoteInd
Independent Audit Fincl StmtYes (1)IndependentAuditFinclStmtInd
Consolidated Audit Fincl Stmt0ConsolidatedAuditFinclStmtInd
School Operating0SchoolOperatingInd
Foreign Office0ForeignOfficeInd
Foreign Activities0ForeignActivitiesInd
More Than5000 K To Org0MoreThan5000KToOrgInd
More Than5000 K To Individuals0MoreThan5000KToIndividualsInd
Professional Fundraising0ProfessionalFundraisingInd
Fundraising Activities0FundraisingActivitiesInd
Gaming Activities0GamingActivitiesInd
Operate Hospital0OperateHospitalInd
Grants To Organizations0GrantsToOrganizationsInd
Grants To IndividualsYes (1)GrantsToIndividualsInd
Schedule J Required0ScheduleJRequiredInd
Tax Exempt Bonds0TaxExemptBondsInd
Engaged In Excess Benefit Trans0EngagedInExcessBenefitTransInd
PY Excess Benefit Trans0PYExcessBenefitTransInd
Loan OutstandingYes (1)LoanOutstandingInd
Grant To Related Person0GrantToRelatedPersonInd
Business Rln With Org Mem0BusinessRlnWithOrgMemInd
Business Rln With Fam Mem0BusinessRlnWithFamMemInd
Business Rln With35 Ctrl Ent0BusinessRlnWith35CtrlEntInd
Deductible Non Cash Contri0DeductibleNonCashContriInd
Deductible Art Contribution0DeductibleArtContributionInd
Terminate Operations0TerminateOperationsInd
Partial Liquidation0PartialLiquidationInd
Disregarded Entity0DisregardedEntityInd
Related Entity0RelatedEntityInd
Related Organization Ctrl Ent0RelatedOrganizationCtrlEntInd
Trnsfr Exmpt Non Chrtbl Rltd Org0TrnsfrExmptNonChrtblRltdOrgInd
Activities Conducted Prtshp0ActivitiesConductedPrtshpInd
Schedule O RequiredYes (1)ScheduleORequiredInd
IRP Document1IRPDocumentCnt
IRP Document W2 G0IRPDocumentW2GCnt
Backup Wthld ComplianceYes (1)BackupWthldComplianceInd
Employee0EmployeeCnt
Unrelated Bus Incm Over Limit0UnrelatedBusIncmOverLimitInd
Foreign Financial Account0ForeignFinancialAccountInd
Prohibited Tax Shelter Trans0ProhibitedTaxShelterTransInd
Taxable Party Notification0TaxablePartyNotificationInd
Nondeductible Contributions0NondeductibleContributionsInd
Quid Pro Quo Contributions0QuidProQuoContributionsInd
Form8282 Property Disposed Of0Form8282PropertyDisposedOfInd
Indoor Tanning Services0IndoorTanningServicesInd
Subj To Tax Rmnrtn Ex Prcht Pymt0SubjToTaxRmnrtnExPrchtPymtInd
Subject To Excs Tax Net Invst Inc0SubjectToExcsTaxNetInvstIncInd
Info In Schedule O Part VIYes (X)InfoInScheduleOPartVIInd
Governing Body Voting Members3GoverningBodyVotingMembersCnt
Independent Voting Member0IndependentVotingMemberCnt
Family Or Business RlnYes (1)FamilyOrBusinessRlnInd
Delegation Of Mgmt Duties0DelegationOfMgmtDutiesInd
Change To Org Documents0ChangeToOrgDocumentsInd
Material Diversion Or Misuse0MaterialDiversionOrMisuseInd
Members Or Stockholders0MembersOrStockholdersInd
Election Of Board Members0ElectionOfBoardMembersInd
Decisions Subject To Approva0DecisionsSubjectToApprovaInd
Minutes Of Governing BodyYes (1)MinutesOfGoverningBodyInd
Minutes Of CommitteesYes (1)MinutesOfCommitteesInd
Officer Mailing Address0OfficerMailingAddressInd
Local Chapters0LocalChaptersInd
Form990 Provided To Gvrn BodyYes (1)Form990ProvidedToGvrnBodyInd
Conflict Of Interest PolicyYes (1)ConflictOfInterestPolicyInd
Annual Disclosure Covered PrsnYes (1)AnnualDisclosureCoveredPrsnInd
Regular Monitoring EnfrcYes (1)RegularMonitoringEnfrcInd
Whistleblower PolicyYes (1)WhistleblowerPolicyInd
Document Retention PolicyYes (1)DocumentRetentionPolicyInd
Compensation Process CEO0CompensationProcessCEOInd
Compensation Process Other0CompensationProcessOtherInd
Investment In Joint Venture0InvestmentInJointVentureInd
States Where Copy Of Return Is FldCAStatesWhereCopyOfReturnIsFldCd
Upon RequestYes (X)UponRequestInd

Books In Care Of Detail BooksInCareOfDetail

Business Name BusinessName

FieldValueIRS element (for citing)
Business Name Line1JOHN ZABASKYBusinessNameLine1Txt
FieldValueIRS element (for citing)
Phone8055481637PhoneNum

US Address USAddress

FieldValueIRS element (for citing)
Address Line11901 S VICTORIA AVENUE SUITE 109AddressLine1Txt
CityOXNARDCityNm
State AbbreviationCAStateAbbreviationCd
ZIP93035ZIPCd
FieldValueIRS element (for citing)
No Listed Persons CompensatedYes (X)NoListedPersonsCompensatedInd

Form990 Part VII Section A Form990PartVIISectionAGrp (3 entries)

TitleTitleTxtAverage Hours Per WeekAverageHoursPerWeekRtAverage Hours Per Week Rltd OrgAverageHoursPerWeekRltdOrgRtIndividual Trustee Or DirectorIndividualTrusteeOrDirectorIndOfficerOfficerIndReportable Comp From OrgReportableCompFromOrgAmtReportable Comp From Rltd OrgReportableCompFromRltdOrgAmtOther CompensationOtherCompensationAmt
BRIGETTE VAYSBERG
SECRETARY, DIRECTOR5.0035.00Yes (X)Yes (X)$0$0$0
SHARON ROWELL
TREASURER, DIRECTOR10.0030.00Yes (X)Yes (X)$0$0$0
JOHN ZABASKY
PRESIDENT, DIRECTOR10.0030.00Yes (X)Yes (X)$0$0$0
FieldValueIRS element (for citing)
Total Reportable Comp From Org$0TotalReportableCompFromOrgAmt
Tot Reportable Comp Rltd Org$0TotReportableCompRltdOrgAmt
Total Other Compensation$0TotalOtherCompensationAmt
Indiv Rcvd Greater Than100 K0IndivRcvdGreaterThan100KCnt
Former Ofcr Employees Listed0FormerOfcrEmployeesListedInd
Total Comp Greater Than150 K0TotalCompGreaterThan150KInd
Compensation From Other Srcs0CompensationFromOtherSrcsInd
Cntrct Rcvd Greater Than100 K0CntrctRcvdGreaterThan100KCnt

Program Service Revenue ProgramServiceRevenueGrp

FieldValueIRS element (for citing)
DescHEALTHCARE SERVICESDesc
Business900099BusinessCd
Total Revenue Column$38,223,703TotalRevenueColumnAmt
Related Or Exempt Func Income$38,223,703RelatedOrExemptFuncIncomeAmt
FieldValueIRS element (for citing)
Total Program Service Revenue$38,223,703TotalProgramServiceRevenueAmt

Investment Income InvestmentIncomeGrp

FieldValueIRS element (for citing)
Total Revenue Column$16TotalRevenueColumnAmt
Exclusion$16ExclusionAmt

Total Revenue TotalRevenueGrp

FieldValueIRS element (for citing)
Total Revenue Column$38,223,719TotalRevenueColumnAmt
Related Or Exempt Func Income$38,223,703RelatedOrExemptFuncIncomeAmt
Unrelated Business Revenue$0UnrelatedBusinessRevenueAmt
Exclusion$16ExclusionAmt

Grants To Domestic Individuals GrantsToDomesticIndividualsGrp

FieldValueIRS element (for citing)
Total$38,140,435TotalAmt
Program Services$38,140,435ProgramServicesAmt

Fees For Services Accounting FeesForServicesAccountingGrp

FieldValueIRS element (for citing)
Total$27,700TotalAmt
Management And General$27,700ManagementAndGeneralAmt

Fees For Services Other FeesForServicesOtherGrp

FieldValueIRS element (for citing)
Total$49,500TotalAmt
Program Services$49,500ProgramServicesAmt

Other Expenses OtherExpensesGrp (2 entries)

DescDescTotalTotalAmtManagement And GeneralManagementAndGeneralAmt
BANK FEES$600$600
TAXES$225$225

Total Functional Expenses TotalFunctionalExpensesGrp

FieldValueIRS element (for citing)
Total$38,218,460TotalAmt
Program Services$38,189,935ProgramServicesAmt
Management And General$28,525ManagementAndGeneralAmt
Fundraising$0FundraisingAmt

Cash Non Interest Bearing CashNonInterestBearingGrp

FieldValueIRS element (for citing)
BOY$4,560BOYAmt
EOY$109,819EOYAmt
FieldValueIRS element (for citing)
Land Bldg Equip Cost Or Other Bss$5,000LandBldgEquipCostOrOtherBssAmt
Land Bldg Equip Accum Deprec$5,000LandBldgEquipAccumDeprecAmt

Land Bldg Equip Basis Net LandBldgEquipBasisNetGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Total Assets TotalAssetsGrp

FieldValueIRS element (for citing)
BOY$4,560BOYAmt
EOY$109,819EOYAmt

Loans From Officers Directors LoansFromOfficersDirectorsGrp

FieldValueIRS element (for citing)
BOY$11,000BOYAmt
EOY$11,000EOYAmt

Unsecured Notes Loans Payable UnsecuredNotesLoansPayableGrp

FieldValueIRS element (for citing)
EOY$100,000EOYAmt

Total Liabilities TotalLiabilitiesGrp

FieldValueIRS element (for citing)
BOY$11,000BOYAmt
EOY$111,000EOYAmt
FieldValueIRS element (for citing)
Org Does Not Follow FASB117Yes (X)OrgDoesNotFollowFASB117Ind

Cap Stk Tr Prin Current Funds CapStkTrPrinCurrentFundsGrp

FieldValueIRS element (for citing)
BOY$500BOYAmt
EOY$500EOYAmt

Pd In Cap Srpls Land Bldg Eqp Fund PdInCapSrplsLandBldgEqpFundGrp

FieldValueIRS element (for citing)
BOY$0BOYAmt
EOY$0EOYAmt

Rtn Earn Endowment Incm Oth Fnds RtnEarnEndowmentIncmOthFndsGrp

FieldValueIRS element (for citing)
BOY-$6,940BOYAmt
EOY-$1,681EOYAmt

Total Net Assets Fund Balance TotalNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY-$6,440BOYAmt
EOY-$1,181EOYAmt

Tot Liab Net Assets Fund Balance TotLiabNetAssetsFundBalanceGrp

FieldValueIRS element (for citing)
BOY$4,560BOYAmt
EOY$109,819EOYAmt
FieldValueIRS element (for citing)
Reconcilation Revenue Expnss$5,259ReconcilationRevenueExpnssAmt
Other Changes In Net Assets$0OtherChangesInNetAssetsAmt
Method Of Accounting AccrualYes (X)MethodOfAccountingAccrualInd
Accountant Compile Or Review0AccountantCompileOrReviewInd
FS AuditedYes (1)FSAuditedInd

FS Audited Basis FSAuditedBasisGrp

FieldValueIRS element (for citing)
Separate Basis Fincl StmtYes (X)SeparateBasisFinclStmtInd
FieldValueIRS element (for citing)
Audit CommitteeYes (1)AuditCommitteeInd
Federal Grant Audit Required0FederalGrantAuditRequiredInd

Schedule A IRS990ScheduleA

FieldValueIRS element (for citing)
Publicly Supported Org509a2Yes (X)PubliclySupportedOrg509a2Ind

Gifts Grants Contris Rcvd509 GiftsGrantsContrisRcvd509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus1 Year$5,000CurrentTaxYearMinus1YearAmt
Total$5,000TotalAmt

Gross Receipts Admissions GrossReceiptsAdmissionsGrp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$34,827,608CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$21,437,258CurrentTaxYearMinus1YearAmt
Current Tax Year$38,223,703CurrentTaxYearAmt
Total$94,488,569TotalAmt

Total509 Total509Grp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$34,827,608CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$21,442,258CurrentTaxYearMinus1YearAmt
Current Tax Year$38,223,703CurrentTaxYearAmt
Total$94,493,569TotalAmt

Amounts Rcvd Dsqlfy Person AmountsRcvdDsqlfyPersonGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Substantial Contributors Amt SubstantialContributorsAmtGrp

FieldValueIRS element (for citing)
Total$0TotalAmt

Subst And Dsqlfy Prsns Tot SubstAndDsqlfyPrsnsTotGrp

FieldValueIRS element (for citing)
Total$0TotalAmt
FieldValueIRS element (for citing)
Public Support Total509$94,493,569PublicSupportTotal509Amt

Total Support Calendar Year TotalSupportCalendarYearGrp

FieldValueIRS element (for citing)
Current Tax Year Minus2 Years$34,827,608CurrentTaxYearMinus2YearsAmt
Current Tax Year Minus1 Year$21,442,258CurrentTaxYearMinus1YearAmt
Current Tax Year$38,223,703CurrentTaxYearAmt
Total$94,493,569TotalAmt
FieldValueIRS element (for citing)
First5 Years509Yes (X)First5Years509Ind

Schedule D IRS990ScheduleD

Equipment EquipmentGrp

FieldValueIRS element (for citing)
Other Cost Or Other Basis$5,000OtherCostOrOtherBasisAmt
Depreciation$5,000DepreciationAmt
Book Value$0BookValueAmt
FieldValueIRS element (for citing)
Total Book Value Land Buildings$0TotalBookValueLandBuildingsAmt
Footnote TextYes (X)FootnoteTextInd
Total Rev Etc Audited Fincl Stmt$38,241,719TotalRevEtcAuditedFinclStmtAmt
Donated Services And Use Fclts$18,000DonatedServicesAndUseFcltsAmt
Revenue Not Reported$18,000RevenueNotReportedAmt
Revenue Subtotal$38,223,719RevenueSubtotalAmt
Revenue Not Reported Fincl Stmt$0RevenueNotReportedFinclStmtAmt
Total Revenue Per Form990$38,223,719TotalRevenuePerForm990Amt
Tot Expns Etc Audited Fincl Stmt$38,236,460TotExpnsEtcAuditedFinclStmtAmt
Donated Services Use Fclts$18,000DonatedServicesUseFcltsAmt
Expenses Not Reported$18,000ExpensesNotReportedAmt
Expenses Subtotal$38,218,460ExpensesSubtotalAmt
Expenses Not Rpt Fincl Stmt$0ExpensesNotRptFinclStmtAmt
Total Expenses Per Form990$38,218,460TotalExpensesPerForm990Amt

Supplemental Information Detail SupplementalInformationDetail

FieldValueIRS element (for citing)
Form And Line ReferencePART X, LINE 2:FormAndLineReferenceDesc
ExplanationTHE ORGANIZATION IS A CALIFORNIA NONPROFIT PUBLIC BENEFIT CORPORATION, WHICH IS EXEMPT FROM INCOME TAXES UNDER INTERNAL REVENUE CODE SECTION 501(C)(3) AND STATE OF CALIFORNIA REVENUE AND TAXATION CODE SECTION 23701(D); THEREFORE, NO PROVISION FOR INCOME TAXES IS REQUIRED. THE FOUNDATION QUALIFIES FOR THE CHARITABLE CONTRIBUTION DEDUCTION UNDER SECTION 170(B) (1) (A) AND HAS BEEN CLASSIFIED AS A FOUNDATION THAT IS NOT A PRIVATE FOUNDATION UNDER SECTION 509(A) (1). THE ORGANIZATION EVALUATES UNCERTAIN TAX POSITIONS, WHEREBY THE EFFECT OF THE UNCERTAINTY WOULD BE RECORDED IF THE OUTCOME WAS CONSIDERED PROBABLE AND REASONABLY ESTIMABLE. AS OF DECEMBER 31, 2021, THE ORGANIZATION HAD NO UNCERTAIN TAX POSITIONS REQUIRING ACCRUAL. THE ORGANIZATION FILES TAX RETURNS IN CALIFORNIA AND U.S. FEDERAL JURISDICTIONS.ExplanationTxt

Schedule I IRS990ScheduleI

FieldValueIRS element (for citing)
Grant Records MaintainedYes (1)GrantRecordsMaintainedInd

Grants Other Asst To Indiv In US GrantsOtherAsstToIndivInUSGrp

FieldValueIRS element (for citing)
Grant TypeSUBSIDIZED HEALTHCAREGrantTypeTxt
Recipient4900RecipientCnt
Cash Grant$38,140,435CashGrantAmt

Schedule L IRS990ScheduleL

Loans Btwn Org Interested Prsn LoansBtwnOrgInterestedPrsnGrp (2 entries)

Relationship With OrgRelationshipWithOrgTxtLoan PurposeLoanPurposeTxtLoan To OrganizationLoanToOrganizationIndOriginal PrincipalOriginalPrincipalAmtBalance DueBalanceDueAmtDefaultDefaultIndBoard Or Committee ApprovalBoardOrCommitteeApprovalIndWritten AgreementWrittenAgreementInd
INSURANCE ADVANCE
COMMON OWNERSHIPTO FUND INSURANCE.Yes (X)$6,000$6,0000Yes (1)0
EQUIPMENT ADVANCE
COMMON OWNERSHIPTO FUND PURCHASE OF EQUIPMENT.Yes (X)$5,000$5,0000Yes (1)0
FieldValueIRS element (for citing)
Total Balance Due$11,000TotalBalanceDueAmt

Schedule O IRS990ScheduleO

Supplemental Information Detail SupplementalInformationDetail (4 entries)

Form And Line ReferenceFormAndLineReferenceDescExplanationExplanationTxt
FORM 990, PART VI, SECTION A, LINE 2SHARON ROWELL (TREASURER) IS THE MOTHER OF BRIGITTE VAYSBERG (SECRETARY).
FORM 990, PART VI, SECTION B, LINE 11BPRIOR TO FILING ITS TAX RETURN, ALL BOARD MEMBERS HAVE THE ABILITY TO REVIEW THE 990 PRIOR TO ITS BEING FILED.
FORM 990, PART VI, SECTION B, LINE 12CWELLNESSWORX BOARD MEMBERS MEET QUARTERLY TO DISCUSS AND REVIEW CONFLICT OF INTEREST POLICY TO MAKE SURE IT IS ENFORCED. MINUTES ARE TAKEN AT ALL MEETINGS.
FORM 990, PART VI, SECTION C, LINE 19THE ORGANIZATION'S GOVERNING DOCUMENTS, CONFLICTS OF INTEREST POLICY, AND FINANCIAL STATEMENTS ARE MAINTAINED AND AVAILABLE TO THE PUBLIC UPON REQUEST, BY PROVIDING COPIES OR AVAILABLE FOR INSPECTION.

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