FORM 1023-EZ for BREAD OF LIFE COMMUNITY CENTER INC

Field Data
EIN 87-0958530
Case Number EO-2021154-000265
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BREAD OF LIFE COMMUNITY CENTER INC
Organization’s Mailing Address 2619 N BIGELOW ST
City PEORIA
State IL
ZIP 61604-3550
Accounting period End 12
Primary contact name LORRAINE WASHINGTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LORRAINE WASHINGTON
PRESIDENT DIRECTOR
2619 N BIGELOW ST
PEORIA IL 61604-3550

Officer/Director/Trustee Two

TRINA WHITE
VICE PRESIDENT DIRECTOR
2625 N MISSOURI AVE
PEORIA IL 61603-1766

Officer/Director/Trustee Three

LAMONT WASHINGTON
DIRECTOR
2619 N BIGELOW ST
PEORIA IL 61604-3550

Officer/Director/Trustee Four

CARMEN GRAYSON
SECRETARY DIRECTOR
1402 W JEFFERSON ST APT6
WASHINGTON IL 61571-1161

Officer/Director/Trustee Five

ETHEL PATES
DIRECTOR
1007 E MELBOURNE AVE
PEORIA IL 61603-2025

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/22/2020
Organization Incorporation State IL
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: Yes
Religious: Yes
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 Yes
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 LORRAINE WASHINGTON
Signature Title PRESIDENT DIRECTOR
Signature Date 6/1/2021

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