FORM 1023-EZ for LCCM INC

Field Data
EIN 47-3762156
Case Number EO-2021104-000245
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LCCM INC
Organization’s Mailing Address 2787 AURORA ROAD
City MELBOURNE
State FL
ZIP 32935
Accounting period End 12
Primary contact name TAMMY R SALTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GENEVIEVE SALTER
PRESIDENT
2212 GARDEN STREET
TITUSVILLE FL 32796

Officer/Director/Trustee Two

GARY SALTER
DIRECTOR
2675 FALCON LANE
MIMS FL 32754

Officer/Director/Trustee Three

TAMMY SALTER
DIRECTOR
2675 FALCON LANE
MIMS FL 32754

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/17/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
Correctness Declaration Yes
Signature Name TAMMY SALTER
Signature Title DIRECTOR
Signature Date 4/8/2021

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