FORM 1023-EZ for LIFT HEALTH ORGANIZATION INC

Field Data
EIN 26-3343850
Case Number EO-2014311-000359
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIFT HEALTH ORGANIZATION INC
Organization’s Mailing Address 3404 N AVON AVE
City TAMPA
State FL
ZIP 33603
Accounting period End 12
Primary contact name KAREEM B YOUNG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KAREEM YOUNG
CEO/DIRECTOR
3404 N JEFFERSON ST
TAMPA FL 33603

Officer/Director/Trustee Two

GORDON FENDERSON
VICE PRESIDENT
644 CESERY BLVD - SUITE 310
JACKSONVILLE FL 32211

Officer/Director/Trustee Three

LENA YOUNG-GREEN
VICE PRESIDENT
3406 N AVON AVE
TAMPA FL 33603

Organization’s website WWW.LIFTHEALTH.ORG
Organization’s email INFO@LIFTHEALTH.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/15/2014
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family Services
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 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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