FORM 1023-EZ for LAST LIFE GAMING

Field Data
EIN 82-1459431
Case Number EO-2017132-000190
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LAST LIFE GAMING
Organization’s Mailing Address 113 CHERRY ST 14472
City SEATTLE
State WA
ZIP 98104-2205
Accounting period End 12
Primary contact name ANAND CAPUR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANAND CAPUR
EXECUTIVE DIRECTOR
113 CHERRY ST 14472
SEATTLE WA 98104-2205

Officer/Director/Trustee Two

LANCE PIOCH
DIRECTOR
3410 INDIAN RD
TOLEDO OH 43606

Officer/Director/Trustee Three

GREGORY BARON
DIRECTOR
15 SOUTH ST FLOOR 1
MANCHESTER NH 03104

Organization’s website WWW.LASTLIFE.GG
Organization’s email TEAM@LASTLIFE.GG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/8/2017
Organization Incorporation State WA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N99 - Recreation, Sports, Leisure, Athletics N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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
Signature Title
Signature Date

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