FORM 1023-EZ for PROACTIVE LIVING FACILITY INC

Field Data
EIN 82-4599378
Case Number EO-2018100-000152
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PROACTIVE LIVING FACILITY INC
Organization’s Mailing Address 45466 N FOOTHILLS DR
City RONAN
State MT
ZIP 59864
Accounting period End 12
Primary contact name JULIE JANSSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RICHARD JANSSEN
CHAIRPERSON
45466 N FOOTHILLS DR
RONAN MT 59864

Officer/Director/Trustee Two

JULIE JANSSEN
VICE CHAIRPERSON
45466 N FOOTHILLS DR
RONAN MT 59864

Officer/Director/Trustee Three

TEENA HOSHER
TREASURER
345 7TH AVE NW
RONAN MT 59864

Officer/Director/Trustee Four

JEANNE CHRISTOPHER
BOARD MEMBER
710 2ND PLACE SW
RONAN MT 59864

Officer/Director/Trustee Five

SHAWNA HANSON
SECRETARY
1504 42ND AVE
MISSOULA MT 59804

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/30/18
Organization Incorporation State MT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G84 - Autism
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 Yes
Compensation of Officer director trustee No
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
Gaming Activity No
Disaster relief assistance No
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name RICHARD JANSSEN
Signature Title CHAIRPERSON
Signature Date 4/5/18

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