FORM 1023-EZ for LIFE HOUSE RECOVERY OF MARYLAND INC

Field Data
EIN 82-1672180
Case Number EO-2019036-000959
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LIFE HOUSE RECOVERY OF MARYLAND INC
Organization’s Mailing Address 128C PINEVIEW AVE
City SEVERNA PARK
State MD
ZIP 21146
Accounting period End 3
Primary contact name JASON MAIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JASON MAIN
PRESIDENT
128 C PINEVIEW AVENUE
SEVERNA PARK MD 21146

Officer/Director/Trustee Two

DIANE BROWN
TREASURER
7207 SAUERS COURT
GLEN BURNIE MD 21061

Officer/Director/Trustee Three

EDWARD JACKSON
VICE PRESIDENT
401 DEERSPRING COURT
SEVERNA PARK MD 21146

Organization’s website
Organization’s email LIFEHOUSEMD1@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/17/17
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F21 - Alcohol, Drug Abuse, Prevention Only
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JASON MAIN
Signature Title PRESIDENT
Signature Date 1/22/19

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