FORM 1023-EZ for EMPOWERING LIFE FOUNDATION

Field Data
EIN 83-3730510
Case Number EO-2019081-000435
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EMPOWERING LIFE FOUNDATION
Organization’s Mailing Address 6950 PLEASENT VIEW ROAD
City ST MARYS
State KS
ZIP 66556
Accounting period End 12
Primary contact name CAROLYN ADAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CAROLYN ADAMS
PRESIDENT+ DIRECTOR
6950 PLEASANT VIEW ROAD
ST MARYS KS 66556

Officer/Director/Trustee Two

KAITLYN ADAMS
SECRETARY + DIRECTOR
6950 PLEASANT VIEW ROAD
ST MARYS KS 66556

Officer/Director/Trustee Three

JAMES BURK
DIRECTOR
1740 N STREET NW STE ONE
WASHINGTON DC 20036

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/19/19
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
Organization’s purpose Charitable: No
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 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 CAROLYN ADAMS
Signature Title PRESIDENT+ DIRECTOR
Signature Date 3/20/19

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