FORM 1023-EZ for ACTIVE FAITH HEALTH MINISTRY INC

Field Data
EIN 85-2277136
Case Number EO-2020224-000558
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ACTIVE FAITH HEALTH MINISTRY INC
Organization’s Mailing Address 344 HUMPREY RD
City LYNNVILLE
State IN
ZIP 47619
Accounting period End 12
Primary contact name SHARON SEXSON-LYLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHARON SEXSON-LYLE
PRESIDENT
344 HUMPHREY RD
LYNNVILLE IN 47619

Officer/Director/Trustee Two

LINDA BAILEY
VICE PRESIDENT
624 OLD PETERSBURG RD
LYNNVILLE IN 47619

Officer/Director/Trustee Three

ALISHA OLIVER
SECRETARY
266 HUMPHREY RD
LYNNVILLE IN 47619

Officer/Director/Trustee Four

BRIANNE GRIMES
TREASURER
1811 W STATE ROUTE 68
LYNNVILLE IN 47619

Officer/Director/Trustee Five

AMY HANSON
BOARD MEMBER
12301 DOGWOOD
EVANSVILLE IN 47725

Organization’s website
Organization’s email SEXSONLYLE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/30/2020
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion 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 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 SHARON SEXSON-LYLE
Signature Title PRESIDENT
Signature Date 8/7/2020

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