FORM 1023-EZ for LIGHTHOUSE LIFE CHANGING MINISTRY INC

Field Data
EIN 81-4446140
Case Number EO-2017156-000320
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIGHTHOUSE LIFE CHANGING MINISTRY INC
Organization’s Mailing Address 766 LANINA PL
City KIHEI
State HI
ZIP 96753
Accounting period End 12
Primary contact name J DANIEL BEIRUTE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALESSANDRO CUCCARO
PRESIDENT DIRECTOR
766 LANINA PL
KIHEI HI 96753

Officer/Director/Trustee Two

JANIS CUCCARO
SECRETARY TREASURER
766 LANINA PL
KIHEI HI 96753

Officer/Director/Trustee Three

HENRY FURR SR
DIRECTOR
7402 78TH ST
RIVERVIEW FL 33578

Organization’s website LIGHTHOUSELCM.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/10/2016
Organization Incorporation State HI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
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 Yes
Donation of funds Yes
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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