FORM 1023-EZ for COMMUNITY LIFE DEVELOPMENT CENTER

Field Data
EIN 83-2518485
Case Number EO-2018333-000212
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COMMUNITY LIFE DEVELOPMENT CENTER
Organization’s Mailing Address 700 HOPE MILLS ROAD
City FAYETTEVILLE
State NC
ZIP 28304
Accounting period End 12
Primary contact name REGINA LASSITER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

REGINA LASSITER
EXECUTIVE DIRECTOR
700 HOPE MILLS ROAD
FAYETTEVILLE NC 28304

Officer/Director/Trustee Two

CLARENCE LASSITER
DIRECTOR
700 HOPE MILLS ROAD
FAYETTEVILLE NC 28304

Officer/Director/Trustee Three

REGGIE LASSITER
DIRECTOR
2820 B 5TH ST NW APT 206
MINOT ND 58703

Officer/Director/Trustee Four

ALETA HILL
DIRECTOR
5620 LAKE VILLAGE DRIVE
MEMPHIS TN 38125

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/23/18
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S99 - Community Improvement, Capacity Building N.E.C.
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 REGINA LASSITER
Signature Title EXECUTIVE DIRECTOR
Signature Date 11/27/18

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