FORM 1023-EZ for EVOLVING LIVES

Field Data
EIN 82-4922110
Case Number EO-2019154-000342
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name EVOLVING LIVES
Organization’s Mailing Address 1101 JORDAN LAKE CT
City LELAND
State NC
ZIP 28451
Accounting period End 12
Primary contact name DEREK BRUNSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEREK BRUNSON
PRESIDENT
914 CAMPBELL ST
WILMINGTON NC 28401

Officer/Director/Trustee Two

ANDRIA HERD
VICE PRESEIDENT
296 SUNNYBROOK WAY
LELAND NC 28451

Officer/Director/Trustee Three

CHRIS SUTTON
SECRUTARY
3500 OLEANDER DRIVE
WILMINGTON NC 28403

Organization’s website
Organization’s email BRUNSONSMMAANDFITNESS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/14/18
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O51 - Youth Community Service Clubs
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 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 No
Correctness Declaration Yes
Signature Name DEREK BRUNSON
Signature Title PRESIDENT
Signature Date 5/30/19

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