FORM 1023-EZ for DAVID LIVES ON

Field Data
EIN 46-4003755
Case Number EO-2019301-000291
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DAVID LIVES ON
Organization’s Mailing Address PO BOX 435
City ANN ARBOR
State MI
ZIP 48106
Accounting period End 12
Primary contact name K G SZCZYPKA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAUL WIDZINSKI
PRESIDENT
433 ORCHARD DR
NORTHVILLE MI 48167

Officer/Director/Trustee Two

MAUREEN SZCZYPKA
SECRETARY
PO BOX 435
ANN ARBOR MI 48106

Officer/Director/Trustee Three

CAITLIN TAGGART
TREASURER
PO BOX 435
ANN ARBOR MI 48106

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/30/13
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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 Yes
Correctness Declaration Yes
Signature Name PAUL WIDZINSKI
Signature Title PRESIDENT
Signature Date 10/18/19
EIN 46-4003755
Case Number EO-2015154-000337
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DAVID LIVES ON
Organization’s Mailing Address PO BOX 435
City ANN ARBOR
State MI
ZIP 48106
Accounting period End 12
Primary contact name MAUREEN SZCZYPKA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

PAUL WIDZINSKI
PRESIDENT
PO BOX 435
ANN ARBOR MI 48106

Officer/Director/Trustee Two

MAUREEN SZCZYPKA
SECRETARY
PO BOX 435
ANN ARBOR MI 48106

Officer/Director/Trustee Three

CAITLIN SZCZYPKA
TREASURER
PO BOX 435
ANN ARBOR MI 48106

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/30/2013
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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
Signature Title
Signature Date

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