FORM 1023-EZ for LYDIAS HOME PBC INC

Field Data
EIN 46-5213559
Case Number EO-2014295-000308
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LYDIAS HOME PBC INC
Organization’s Mailing Address 499 GAZETTA WAY
City WEST PALM BEACH
State FL
ZIP 33413
Accounting period End 12
Primary contact name JENNIFER DIXON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JENNIFER DIXON
PRESIDENT
499 GAZETTA WAY
WEST PALM BEACH FL 33413

Officer/Director/Trustee Two

SHANA-LEE DIXON
SECRETARY
14325 OAKRIDGE CIRCLE APT 811
FORT WORTH TX 76155

Officer/Director/Trustee Three

LASHEENA EVANS
TREASURER
1308 8TH STREET
WEST PALM BEACH FL 33401

Officer/Director/Trustee Four

NADENE PALMER
DIRECTOR
4807 VIA PALM LAKE APT 1508
WEST PALM BEACH FL 33417

Officer/Director/Trustee Five

TREVOR RICHARDS
DIRECTOR
1392 SUMMIT PINES BLVD APT 634
WEST PALM BEACH FL 33415

Organization’s website NA
Organization’s email HELEND3211@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/24/2014
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P42 - Single Parent Agencies, Services
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 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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