FORM 1023-EZ for LOSE TO WIN COMMUNITY OUTREACH INC

Field Data
EIN 81-4899859
Case Number EO-2020240-000402
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LOSE TO WIN COMMUNITY OUTREACH INC
Organization’s Mailing Address 50609 LANTANA AVE
City CHARLOTTE
State NC
ZIP 28212
Accounting period End 12
Primary contact name ANDREA HALL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANDREA HALL
PRESIDENT/CEO
5609 LANTANA AVE
CHARLOTTE NC 28212

Officer/Director/Trustee Two

ALISON DENT
VICE PRESIDENT
24 LEE AVE
BRIDGEPORT CT 06605

Officer/Director/Trustee Three

ERIC DEBOURGH
SECRETARY
5442 LANTANA AVE
CHARLOTTE NC 28212

Officer/Director/Trustee Four

JAMES HALL
TREASURER
5613 LANTANA AVE
CHARLOTTE NC 28212

Officer/Director/Trustee Five

ANGELA BALDWIN
BOARD MEMBER
340 WILLOW STREET
BRIDEPORT CT 06610

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/23/2017
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
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 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 Yes
Correctness Declaration Yes
Signature Name ANDREA HALL
Signature Title PRESIDENT/CEO
Signature Date 8/25/2020

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