FORM 1023-EZ for LIFELONG HEALTH & FITNESS

Field Data
EIN 83-4511932
Case Number EO-2019119-000288
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LIFELONG HEALTH & FITNESS
Organization’s Mailing Address 13789 LOWE ST
City CHANTILLY
State VA
ZIP 20151-3210
Accounting period End 12
Primary contact name BHASKAR BHAVE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALKA BHAVE
DIRECTOR
13789 LOWE ST
CHANTILLY VA 20151-3210

Officer/Director/Trustee Two

BHASKAR BHAVE
CHIEF FINANCIAL OFFICER
13789 LOWE ST
CHANTILLY VA 20151-3210

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/18/19
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
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 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 BHASKAR BHAVE
Signature Title CHIEF FINANCIAL OFFICER
Signature Date 4/26/19

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