FORM 1023-EZ for TEEN LIFE 101 INCORPORATED

Field Data
EIN 47-4873206
Case Number EO-2015238-000229
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TEEN LIFE 101 INCORPORATED
Organization’s Mailing Address 110 LLOYD LANE
City MARTINSVILLE
State VA
ZIP 24112
Accounting period End 4
Primary contact name TONI DURDEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ERIK BETTS
DIRECTOR
90068 HAYENHURST AVENUE
NORTH HILL CA 91343

Officer/Director/Trustee Two

PAUL GANUS
DIRECTOR
11652 ADDISON STREET
VALLEY VILLAGE CA 91601

Officer/Director/Trustee Three

TOM GOODRICH
DIRECTOR
3642 BIRDSONG AVENUE
THOUSAND OAKS CA 91360

Officer/Director/Trustee Four

TONI THOMAS DURDEN
DIRECTOR
110 LLOYD LANE
MARTINSVILLE VA 24112

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/23/2015
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: No
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 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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