FORM 1023-EZ for LEAVING A LIVING LEGACY INC

Field Data
EIN 82-3863476
Case Number EO-2018005-000133
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LEAVING A LIVING LEGACY INC
Organization’s Mailing Address 2125 OLLADALE DRIVE
City FORT WAYNE
State IN
ZIP 46808
Accounting period End 12
Primary contact name ERIN M HECK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MITCHELL MCKINNEY
PRESIDENT
2125 OLLADALE DRIVE
FORT WAYNE IN 46808

Officer/Director/Trustee Two

ART NORTON
1ST VICE PRESIDENT
2125 OLLADALE DRIVE
FORT WAYNE IN 46808

Officer/Director/Trustee Three

DON STEDGE
2ND VICE PRESIDENT
2125 OLLADALE DRIVE
FORT WAYNE IN 46808

Officer/Director/Trustee Four

BERNIE EBETNO
SECRETARY
2125 OLLADALE DRIVE
FORT WAYNE IN 46808

Officer/Director/Trustee Five

ERIC DORAIS
TREASURER
2125 OLLADALE DRIVE
FORT WAYNE IN 46808

Organization’s website
Organization’s email SECRETARYFOPWAYNE14@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/22/17
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 MITCHELL MCKINNEY
Signature Title PRESIDENT
Signature Date 1/3/18

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