FORM 1023-EZ for FOR LIVING INDEPENDENCE

Field Data
EIN 81-4850476
Case Number EO-2017040-000313
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FOR LIVING INDEPENDENCE
Organization’s Mailing Address 2131 N COLLINS ST SUITE 433 629
City ARLINGTON
State TX
ZIP 76011
Accounting period End 12
Primary contact name CLINTON CLARKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CLINTON CLARKE
CEO
2131 N COLLINS ST SUITE 433 629
ARLINGTON TX 76011

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/4/2017
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E50 - Rehabilitative Medical Services
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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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