FORM 1023-EZ for EMPOWERING LIVES 4 TRANSFORMATION

Field Data
EIN 85-3788937
Case Number EO-2021083-000904
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EMPOWERING LIVES 4 TRANSFORMATION
Organization’s Mailing Address 11585 N HARRELLS FERRY RD APT 6-5
City BATON ROUGE
State LA
ZIP 70816
Accounting period End 6
Primary contact name LADRIKA CAREY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LADRKA CAREY
CFO
48208 ROBERTSON RD
TICKFAW LA 70466

Officer/Director/Trustee Two

MARCEY SCHAFFER
CEO
11585 N HARRELLS FERRY RD APT 6-5
BATON ROUGE LA 70816

Organization’s website
Organization’s email lucille.louise@icloud.com
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/17/2020
Organization Incorporation State LA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: No
Literary: No
Public Safety: Yes
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
Donation of funds Yes
Conducting Activities Outside of United States Yes
Financial transactions with officers Yes
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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 Yes
Correctness Declaration Yes
Signature Name MARCEY SCHAFFER
Signature Title CEO
Signature Date 11/16/2020

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