FORM 1023-EZ for IMPACT FOR LIFE MINISTRIES

Field Data
EIN 47-2526023
Case Number EO-2015054-000234
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name IMPACT FOR LIFE MINISTRIES
Organization’s Mailing Address 11001 N 99TH AVE STE 116-89
City PEORIA
State AZ
ZIP 85345
Accounting period End 12
Primary contact name JOHNNY JONES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JOHNNY JONES
PRESIDENT, DIRECTOR
11001 N 99TH AVE STE 116-89
PEORIA AZ 85345

Officer/Director/Trustee Two

ASAVA DUNN
VICE PRESIDENT, DIRECTOR
8701 W WASHINGTON AVE
TOLLESON AZ 85353

Officer/Director/Trustee Three

MONICA LATEZ
SECRETARY, TREASURER, DIRECTOR
8923 W ACOMA DR
PEORIA AZ 85381

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/6/2014
Organization Incorporation State AZ
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: 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 No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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