FORM 1023-EZ for LIFE AFTER PLACEMENT

Field Data
EIN 81-1851093
Case Number EO-2016350-000279
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIFE AFTER PLACEMENT
Organization’s Mailing Address 1328 GATES HEAD COURT
City SYRACUSE
State UT
ZIP 84075
Accounting period End 12
Primary contact name LYNEA KRUKIEWICZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LYNEA KRUKIEWICZ
DIRECTOR
1328 GATES HEAD COURT
SYRACUSE UT 84075

Officer/Director/Trustee Two

ROBERT SPEARS
DIRECTOR
1328 GATES HEAD COURT
SYRACUSE UT 84075

Officer/Director/Trustee Three

CRAIG MITCHELL
DIRECTOR
5922 SOUTH 2125 EAST
OGDEN UT 84403

Officer/Director/Trustee Four

SAMANTHA MARIE GARCIA
DIRECTOR
2197 BRIGANTINE BLVD
GREENBACKVILLE VA 23356

Organization’s website LIFEAFTERPLACEMENT.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/25/2016
Organization Incorporation State UT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P31 - Adoption
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 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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