FORM 1023-EZ for COMMUNITY LIFE CENTER OF SOUTHERN CALVERT COUNTY INC

Field Data
EIN 81-3862185
Case Number EO-2016308-000247
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COMMUNITY LIFE CENTER OF SOUTHERN CALVERT COUNTY INC
Organization’s Mailing Address 10210 HG TRUEMAN ROAD
City LUSBY
State MD
ZIP 20657
Accounting period End 12
Primary contact name JAMES YOE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES YOE
DIRECTOR
PO BOX 277
LUSBY MD 20657

Officer/Director/Trustee Two

JAMES SHEPHARD
DIRECTOR
PO BOX 277
LUSBY MD 20657

Officer/Director/Trustee Three

MARGIT MILLER
DIRECTOR
PO BOX 277
LUSBY MD 20657

Officer/Director/Trustee Four

MELLISA CARNES
DIRECTOR
PO BOX 277
LUSBY MD 20657

Officer/Director/Trustee Five

ANNE GROSS
DIRECTOR
PO BOX 277
LUSBY MD 20657

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/12/2016
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - Fund Raising and/or Fund Distribution
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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