FORM 1023-EZ for NATIONSLIFE INC

Field Data
EIN 47-4724928
Case Number EO-2015223-000077
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NATIONSLIFE INC
Organization’s Mailing Address 1163 CHAPPELL MILL ROAD
City JACKSON
State GA
ZIP 30233
Accounting period End 12
Primary contact name TIMOTHY HALEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TIMOTHY HALEY
CEO
1163 CHAPPELL MILL ROAD
JACKSON GA 30233

Officer/Director/Trustee Two

MICAH USRY
CFO
20 WINDPHER RIDGE
HAMPTON GA 30228

Officer/Director/Trustee Three

HANNAH HALEY
SECRETARY
1163 CHAPPELL MILL ROAD
JACKSON GA 30233

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/28/2015
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
Religious: Yes
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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