FORM 1023-EZ for BREAD OF LIFE LEXINGTON INC

Field Data
EIN 82-1862145
Case Number EO-2017170-000148
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BREAD OF LIFE LEXINGTON INC
Organization’s Mailing Address PO BOX 572
City LEXINGTON
State KY
ZIP 40588
Accounting period End 12
Primary contact name MICHAEL MILLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL MILLER
DIRECTOR
104 TWELFTH STREET
LEXINGTON KY 40505

Officer/Director/Trustee Two

THOMAS GORNIAK
DIRECTOR
1229 EMBRY STREET
LEXINGTON KY 40508

Officer/Director/Trustee Three

C WILLIAM CONNORS
DIRECTOR
3288 CARLSBAD COURT
LEXINGTON KY 40517

Officer/Director/Trustee Four

CHRISTOPHER JENKINS
DIRECTOR
3900 CROSBY DRIVE NO 1812
LEXINGTON KY 40515

Officer/Director/Trustee Five

R GREG MCMORROW
DIRECTOR
103 WINDWARD WAY
NICHOLASVILLE KY 40356

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/17/2017
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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