FORM 1023-EZ for LOW LIFE ON WHEELS INC

Field Data
EIN 47-4695036
Case Number EO-2016004-000255
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LOW LIFE ON WHEELS INC
Organization’s Mailing Address 1446 DOUGLAS DR
City ELLERSLIE
State GA
ZIP 31807-5626
Accounting period End 12
Primary contact name RODNEY B WORTHEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RODNEY WORTHEN
PRESIDENT
1446 DOUGLAS DR
ELLERSLIE GA 31807-5626

Officer/Director/Trustee Two

TIMOTHY HAYES
VICE PRESIDENT
4807 22ND AVE
PHENIX CITY AL 36867-1711

Officer/Director/Trustee Three

AKEENA ELLISON
SECRETARY
338 GILBERT RD
MANCHESTER GA 31816-7006

Officer/Director/Trustee Four

KISSIMMEE BUSSEY-HARVEY
TREASURER
4744 TERESA ST
COLUMBUS GA 31907-4076

Organization’s website
Organization’s email LIFEONWHEELS15@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/8/2015
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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 Yes
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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