FORM 1023-EZ for ROWLAND BUTLER LIVING LIFE LEGACY

Field Data
EIN 81-4595063
Case Number EO-2016347-000249
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ROWLAND BUTLER LIVING LIFE LEGACY
Organization’s Mailing Address 1533 JAMESTOWN DRIVE
City MURRAY
State UT
ZIP 84121
Accounting period End 12
Primary contact name JC KIRCH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROWLAND BUTLER
CHAIRMAN AND DIRECTOR
4829 SO ARBOR CIRCLE
HOLLADAY UT 84117

Officer/Director/Trustee Two

JC KIRCH
DIRECTOR AND PRESIDENT
1533 JAMESTOWN DRIVE
MURRAY UT 84121

Officer/Director/Trustee Three

GERI HENICH
DIRECTOR AND SECRETARY
821 N 250 W
BOUNTIFUL UT 84010

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/5/2016
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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