FORM 1023-EZ for TAKE BACK YOUR LIFE

Field Data
EIN 81-5126744
Case Number EO-2018150-000369
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TAKE BACK YOUR LIFE
Organization’s Mailing Address 1 CLYM STREET
City PROVIDENCE
State RI
ZIP 2908
Accounting period End 12
Primary contact name DARLENE CORREIA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DARLENE CORREIA
PRESIDENT
1 CLYM STREET
PROVIDENCE RI 2908

Officer/Director/Trustee Two

DARLENE CORREIA
DIRECTOR
1 CLYM STREET
PROVIDENCE RI 2908

Officer/Director/Trustee Three

JOSE CORREIA
DIRECTOR
1 CLYM STREET
PROVIDENCE RI 2908

Officer/Director/Trustee Four

SANDRA PARASCANDOLO
DIRECTOR
18 SAGE COURT
JOHNSTON RI 2919

Organization’s website
Organization’s email TAKEBACKYOURLIFE7@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/11/16
Organization Incorporation State RI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P43 - Family Violence Shelters, 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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DARLENE CORREIA
Signature Title DIRECTOR
Signature Date 5/25/18

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