FORM 1023-EZ for THE LISA EMMA FOUNDATION INC

Field Data
EIN 84-4954752
Case Number EO-2020107-000115
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE LISA EMMA FOUNDATION INC
Organization’s Mailing Address 2209 HYDE PARK RD
City JACKSONVILLE
State FL
ZIP 32210
Accounting period End 3
Primary contact name SHELLISE DONNERSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHELLISE DONNERSON
PRESIDENT
2209 HYDE PARK RD
JACKSONVILLE FL 32210

Officer/Director/Trustee Two

TERESA HOLLAND
TREASURER
3029 BAVARIAN WEST DR 541
INDIANAPOLIS IN 46235

Officer/Director/Trustee Three

LARINZO DONNERSON
DIRECTOR
3029 BAVARIAN WEST DR 541
INDIANAPOLIS IN 46235

Officer/Director/Trustee Four

CHRISTOPHER MITZS
DIRECTOR
3029 BAVARIAN WEST DR 541
INDIANAPOLS IN 46235

Officer/Director/Trustee Five

PHILIP HADDEN HADDEN
SECRETARY
2209 HYDE PARK RD
JACKSONVILLE FL 32210

Organization’s website
Organization’s email LEF@CONTACTUSCENTER.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/3/2020
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SHELLISE DONNERSON
Signature Title PRESIDENT
Signature Date 4/14/2020

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