FORM 1023-EZ for LILLIS LIGHTHOUSE INC

Field Data
EIN 86-1640673
Case Number EO-2021082-000808
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LILLIS LIGHTHOUSE INC
Organization’s Mailing Address 249 EMERSON DR NW
City PALM BAY
State FL
ZIP 32907
Accounting period End 12
Primary contact name GALEASIA L CARTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GALEASIA CARTER-VELEZ
EXECUTIVE DIRECTOR
249 EMERSON DR NW
PALM BAY FL 32807

Officer/Director/Trustee Two

TANGI WILLIAMS
CHIEF FINANCIAL OFFIER
4200 SKYWAY DRIVE
COCOA FL 32926

Officer/Director/Trustee Three

KATRINA MCQUEEN
DIRECTOR OF AFFAIRS
320 EAST SEWARD STREET
TAMPA FL 33604

Officer/Director/Trustee Four

GENESIS CRUZ
SECRETARY
2225 JULIANNA COURT
SAINT CLOUD FL 34769

Organization’s website
Organization’s email lillislighthouseinc@gmail.com
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/7/2021
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name GALEASIA CARTER-VELEZ
Signature Title EXECUTIVE DIRECTOR
Signature Date 1/31/2021

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