FORM 1023-EZ for SECOND CHANCE AT LIFE FOUNDATION ORG

Field Data
EIN 82-1194779
Case Number EO-2017156-000370
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SECOND CHANCE AT LIFE FOUNDATION ORG
Organization’s Mailing Address 2013 CRAWFORD RD
City RALEIGH
State NC
ZIP 27610
Accounting period End 12
Primary contact name KEITH PARKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KEITH PARKER
OFFICER
2013CRAWFORD RD
RALEIGH NC 27610

Officer/Director/Trustee Two

LISA NORRIS
DIRECTOR
5360MERYTON PKWY
RALEIGH NC 27616

Organization’s website SEONDCHANCEATLIFEFOUNDATIONORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/2/2017
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A12 - Fund Raising and/or Fund Distribution
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 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
Signature Title
Signature Date

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