FORM 1023-EZ for PROJECT HEALTHY LIVING INC

Field Data
EIN 47-1044100
Case Number EO-2015327-000190
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PROJECT HEALTHY LIVING INC
Organization’s Mailing Address 115 MISSISSIPPI AVE SE
City WASHINGTON
State DC
ZIP 20032
Accounting period End 12
Primary contact name ROBERT BARRETT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ROBERT BARRETT
PRESIDENT/DIRECTOR
115 MISSISSIPPI AVE SE
WASHINGTON DC 20032

Officer/Director/Trustee Two

JABARI BRUTON-BARRETT
TREASURER/DIRECTOR
115 MISSISSIPPI AVE SE
WASHINGTON DC 20032

Officer/Director/Trustee Three

DARRYL MOCH
SECRETARY/DIRECTOR
115 MISSISSIPPI AVE SE
WASHINGTON DC 20032

Officer/Director/Trustee Four

KEN PETTIGREW
DIRECTOR
115 MISSISSIPPI AVE SE
WASHINGTON DC 20032

Officer/Director/Trustee Five

TERRANCE PAYTON
DIRECTOR
115 MISSISSIPPI AVE SE
WASHINGTON DC 20032

Organization’s website
Organization’s email THEMANDATEDMV@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/2/2015
Organization Incorporation State DC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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
Signature Title
Signature Date

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