FORM 1023-EZ for REAL 5 STAR LIFE

Field Data
EIN 83-1513915
Case Number EO-2018225-000275
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name REAL 5 STAR LIFE
Organization’s Mailing Address 6630 NEWBURY LANE
City PARMA HEIGHTS
State OH
ZIP 44130
Accounting period End 12
Primary contact name NOUVELLE L GONZALO ESQUIRE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NEIL SARCYK
PRESIDENT
6630 NEWBURY LANE
PARMA HEIGHTS OH 44130

Officer/Director/Trustee Two

CLINT ZMIJA
TREASURER
6630 NEWBURY LANE
PARMA HEIGHTS OH 44130

Officer/Director/Trustee Three

KYLE LOTT
SECRETARY
6630 NEWBURY LANE
PARMA HEIGHTS OH 44130

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/9/18
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S12 - Fund Raising and/or Fund Distribution
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 NEIL SARCYK
Signature Title PRESIDENT
Signature Date 8/9/18

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