FORM 1023-EZ for HOUSE OF LYDIA

Field Data
EIN 81-5418926
Case Number EO-2017053-000215
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name HOUSE OF LYDIA
Organization’s Mailing Address 3663 GRAND AVE UNIT 903
City DES MOINES
State IA
ZIP 50312
Accounting period End 12
Primary contact name DANIEL EVANS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NANCY EVANS
CHAIRMAN
3663 GRAND AVE UNIT 903
DES MOINES IA 50312

Officer/Director/Trustee Two

WENDY PIXLER
VICE-CHAIRMAN
50145 GOLDLEAF DRIVE
AMES IA 50014

Officer/Director/Trustee Three

DANIEL EVANS
TREASURER
3663 GRAND AVE UNIT 903
DES MOINES IA 50312

Officer/Director/Trustee Four

MARY MCCOY
SECRETARY
3663 GRAND AVE UNIT 908
DES MOINES IA 50312

Officer/Director/Trustee Five

NANCY JONES
DIRECTOR
520 SOUTH 69 STREET
OMAHA NE 68106

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/30/2017
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code J22 - Vocational Training
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
Signature Title
Signature Date

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