FORM 1023-EZ for THE LAZARUS HOUSE INC

Field Data
EIN 85-3347606
Case Number EO-2020302-000122
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE LAZARUS HOUSE INC
Organization’s Mailing Address 2104 NE 51ST TERRACE
City KANSAS CITY
State MO
ZIP 64118
Accounting period End 12
Primary contact name LUCAS K SCOTT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DERELL GRIMM
PRESIDENT
2104 NE 51ST TERRACE
KANSAS CITY MO 64118

Officer/Director/Trustee Two

CLARENCE SADLER
SECRETARY
337 N WHITE AVE
KANSAS CITY MO 64123

Officer/Director/Trustee Three

FRANK HARVEY
TREASURER
1106 TROY DRIVE
ST LOUIS MO 63137

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/6/2020
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F22 - Alcohol, Drug Abuse, Treatment Only
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: No
Scientific: Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DERELL GRIMM
Signature Title PRESIDENT
Signature Date 10/26/2020

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