FORM 1023-EZ for LB LIFE SKILLS CORPORATION

Field Data
EIN 47-1114162
Case Number EO-2015058-000231
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LB LIFE SKILLS CORPORATION
Organization’s Mailing Address 9375 ARCHIBALD AVENUE SUITE 104
City RANCHO CUCAMONGA
State CA
ZIP 91730
Accounting period End 12
Primary contact name LINDA BURTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JOSEPH BUROTN
PRESIDENT
11660 CHURCH STREET APT 15
RANCHO CUCAMONGA CA 91730

Officer/Director/Trustee Two

DELILA DZIA
SECRETARY
18032 PASSIONFLOWER LN
SAN BERNARDINO CA 92407

Officer/Director/Trustee Three

JOSE CHALICO
TREASURER
965 REBECCA WAY APT 102
CORONA CA 92880

Officer/Director/Trustee Four

LINDA BURTON
EXECUTIVE DIRECTOR
11660 CHURCH STREET APT 15
RANCHO CUCAMONGA CA 91730

Organization’s website WWW.LBLIFESKILLS.COM
Organization’s email LINDA@LBLIFESKILLS.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/2/2014
Organization Incorporation State CA
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 Yes
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
Signature Title
Signature Date

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