FORM 1023-EZ for LIZAM HEALTH ORGANIZATION INC

Field Data
EIN 68-0614717
Case Number EO-2020135-000026
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LIZAM HEALTH ORGANIZATION INC
Organization’s Mailing Address 459 BROADWAY SUITE 306
City EVERETT
State MA
ZIP 02149
Accounting period End 12
Primary contact name OSILAMA OSIME
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

OSILAMA OSIME
PRESIDENT
41 WINTHROP PARKWAY
REVERE MA 02151

Officer/Director/Trustee Two

DAVID IYALOMHE
DIRECTOR
9863 NOVARA LANE
CYPRESS CA 90630

Officer/Director/Trustee Three

JOSEPH IGIETSEME
DIRECTOR
982 CARLISLE ROAD
STONE MOUNTAIN GA 30084

Officer/Director/Trustee Four

NELSON TENEBE
TREASURER
509 PLUMB BRANCH COURT
MCDONOUGH GA 30253

Officer/Director/Trustee Five

GODWIN OYAKIRE
SECRETARY
11 SPRINGHOUSE TERRACE UNIT 35
SEEKONK MA 02770

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/22/2007
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: Yes
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 Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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 Yes
Correctness Declaration Yes
Signature Name OSILAMA OSIME
Signature Title PRESIDENT
Signature Date 5/11/2020

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