FORM 1023-EZ for BE ALIVE

Field Data
EIN 82-2109457
Case Number EO-2017193-000256
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BE ALIVE
Organization’s Mailing Address 17250 KINGS WAY DR
City ANCHORAGE
State AK
ZIP 99516
Accounting period End 12
Primary contact name CASEY RANDALL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CASEY RANDALL
DIRECTOR
17250 KINGS WAY
ANCHORAGE AK 99516

Officer/Director/Trustee Two

MATT RANDALL
DIRECTOR
17250 KINGS WAY
ANCHORAGE AK 99516

Officer/Director/Trustee Three

TODD LIST
DIRECTOR
1521 I STREET
ANCHORAGE AK 99501

Organization’s website
Organization’s email BEALIVEAK@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/6/2016
Organization Incorporation State AK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
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 Yes
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
Signature Title
Signature Date

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