FORM 1023-EZ for SECOND CHANCE EMBRACE THE GIFT OF LIFE

Field Data
EIN 47-2949056
Case Number EO-2015274-000333
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SECOND CHANCE EMBRACE THE GIFT OF LIFE
Organization’s Mailing Address 3958 SNOW ROAD N SUITE L
City SEMMES
State AL
ZIP 36575
Accounting period End 6
Primary contact name CARMEN FARR DOWLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DAVID MILLER
DIRECTOR
3958 SNOW ROAD N SUITE L
SEMMES AL 36575

Officer/Director/Trustee Two

JOHN BRUENS
BOARD MEMBER
128 SUBER ROAD
COLUMBIA SC 29210

Officer/Director/Trustee Three

JUDY BURHAM
BOARD MEMBER
3726 BAYFRONT ROAD
MOBILE AL 36605

Officer/Director/Trustee Four

BRIAN LUM
BOARD MEMBER
10520 MONT PELIER CIRCLE
ORLANDO FL 32821

Officer/Director/Trustee Five

KURT WILTCHER
BOARD MEMBER
175 S GREGORY ST
ECRU MS 38891

Organization’s website WWW.SECONDCHANCEEMBRACELIFE.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/16/2015
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B20 - Elementary, Secondary Education, K - 12
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 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 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
Signature Title
Signature Date

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