FORM 1023-EZ for CHARLIE MIKE LIFE

Field Data
EIN 84-2972445
Case Number EO-2019357-000343
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHARLIE MIKE LIFE
Organization’s Mailing Address 1310 BAY HARBOR DRIVE 202
City PALM HARBOR
State FL
ZIP 34685
Accounting period End 12
Primary contact name CHANDLER LONERGAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHANDLER LONERGAN
CEO CFO
1310 BAY HARBOR DRIVE 202
PALM HARBOR FL 34685

Officer/Director/Trustee Two

TOBY VADO
COO
302 MAPLE HILL STREET
PLAINFIELD IN 46168

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/7/2019
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
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 Yes
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 Yes
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 CHANDLER LONERGAN
Signature Title CEO CFO
Signature Date 12/19/2019

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