FORM 1023-EZ for LIVES IN TRANSFORMATION

Field Data
EIN 81-5155535
Case Number EO-2017032-000177
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIVES IN TRANSFORMATION
Organization’s Mailing Address 804 E CHURCH STREET
City MARION
State OH
ZIP 43302
Accounting period End 12
Primary contact name AMISTY REYNOLDS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KERI FITZGERALD
BOARD MEMBER
516 KILBURY
MARION OH 43302

Officer/Director/Trustee Two

ASHONDA BAKER
BOARD MEMBER
453 MERCHANT AVENUE
MARION OH 43302

Officer/Director/Trustee Three

RONITA JACKSON
BOARD MEMBER
8102 CHATEAU LANE
WESTERVILLE OH 43082

Officer/Director/Trustee Four

HEIDI HARDY
BOARD MEMBER
604 MIAMI STREET
MARION OH 43302

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/30/2017
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K40 - Nutrition Programs
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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