FORM 1023-EZ for PROFOUND LIFE FOUNDATION
| Field | Data |
|---|---|
| EIN | 87-2616215 |
| Case Number | EO-2021259-000304 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | PROFOUND LIFE FOUNDATION |
| Organization’s Mailing Address | 1712 PIONEER AVE STE 500 |
| City | CHEYENNE |
| State | WY |
| ZIP | 82001 |
| Accounting period End | 12 |
| Primary contact name | JOHN SCRIVENER |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
JOHN SCRIVENER
DIRECTOR
1895 VINEYARD ROAD
FALLING WATERS WV 25419
Officer/Director/Trustee Two
LISA SCRIVENER
DIRECTOR
1895 VINEYARD ROAD
FALLING WATERS WV 25419
| Organization’s website | PROFOUNDLIFE.CARE |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 9/13/2021 |
| Organization Incorporation State | WY |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | P20 - Human Service Organizations - Multipurpose |
| 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 | JOHN SCRIVENER |
| Signature Title | DIRECTOR |
| Signature Date | 9/14/2021 |
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