FORM 1023-EZ for BALANCED LIFE FOUNDATION

Field Data
EIN 83-3242117
Case Number EO-2019073-000455
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BALANCED LIFE FOUNDATION
Organization’s Mailing Address 1900 AVENIDA HIGH VIEW
City DRIFTWOOD
State TX
ZIP 78619
Accounting period End 12
Primary contact name VALERIE VARNEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL UZUANIS
PRESIDENT/DIRECTOR
1900 AVENIDA HIGH VIEW
DRIFTWOOD

Officer/Director/Trustee Two

RICHARD UZUANIS
TREASURER/DIRECTOR
1900 AVENIDA HIGH VIEW
DRIFTWOOD TX 78619

Officer/Director/Trustee Three

MADALINE UZUANIS
SECRETARY/DIRECTOR
1900 AVENIDA HIGH VIEW
DRIFTWOOD TX 78619

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/19/19
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K40 - Nutrition Programs
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 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 MICHAEL UZUANIS
Signature Title PRESIDENT/DIRECTOR
Signature Date 3/12/19

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