FORM 1023-EZ for PC4LIFE

Field Data
EIN 83-2000587
Case Number EO-2019142-000242
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PC4LIFE
Organization’s Mailing Address 6311 FRANCIS ST APT A
City PALM BEACH GARDENS
State FL
ZIP 33458
Accounting period End 12
Primary contact name EDWIN HARPER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EDWIN HARPER
PRESIDENT
6311 FRANCIS ST APT A
JUPITER FL 33458

Officer/Director/Trustee Two

ANITA GRAY
TREASURER
6311 FRANCIS ST APT A
JUPITER FL 33458

Officer/Director/Trustee Three

RHODA ROLLS-SAUNDERS
VICE PRESIDENT
6311 FRANCIS ST APT A
JUPITER FL 33458

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/24/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P01 - Alliance/Advocacy Organizations
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 EDWIN HARPER
Signature Title PRESIDENT
Signature Date 5/20/19

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