FORM 1023-EZ for LIFELINE GLOBAL FOUNDATION

Field Data
EIN 47-5288649
Case Number EO-2015323-000221
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIFELINE GLOBAL FOUNDATION
Organization’s Mailing Address 13901 S 4200 RD
City CLAREMORE
State OK
ZIP 74017
Accounting period End 12
Primary contact name SHELBY DUNCAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

YVANN KARAMOKO
PRESIDENT
13901 S 4200 RD
CLAREMORE OK 74017

Officer/Director/Trustee Two

SHELBY DUNCAN
SECRETARY
13901 S 4200 RD
CLAREMORE OK 74017

Officer/Director/Trustee Three

JOSUE BAMPENDE
VICE-PRESIDENT
13901 S 4200 RD
CLAREMORE OK 74017

Officer/Director/Trustee Four

TAKUDZWA SAMUPUNGA
CFO
13901 S 4200 RD
CLAREMORE OK 74017

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/9/2015
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - 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 Yes
Donation of funds Yes
Conducting Activities Outside of United States Yes
Financial transactions with officers Yes
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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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