FORM 1023-EZ for LIFES POTENTIAL SERVICES INC

Field Data
EIN 20-1643998
Case Number EO-2015299-000386
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIFES POTENTIAL SERVICES INC
Organization’s Mailing Address 389 SILVER RUN VALLEY ROAD
City WESTMINSTER
State MD
ZIP 21158
Accounting period End 12
Primary contact name KAREN BYRD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DOUGLAS SANDS
PRESIDENT
696 WEST WATERSVILLE ROAD
MOUNT AIRY MD 21771-3640

Officer/Director/Trustee Two

JOHN GREEN
VICE PRESIDENT
8 SECRETARIAT COURT
OWINGS MILLS MD 21117-6155

Officer/Director/Trustee Three

JACKIE THOMAS
SECRETARY
4180 JEFFERSON AVENUE
SYKESVILLE MD 21784-9700

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/10/2004
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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