FORM 1023-EZ for LIGHTHOUSE FAMILY SERVICES INC

Field Data
EIN 81-4966147
Case Number EO-2017044-000224
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIGHTHOUSE FAMILY SERVICES INC
Organization’s Mailing Address 12209 EASTERN AVENUE
City MIDDLE RIVER
State MD
ZIP 21220
Accounting period End 12
Primary contact name CLAUDIA JEFFERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CLAUDIA JEFFERS
PRESIDENT
12209 EASTERN AVENUE
MIDDLE RIVER MD 21220

Officer/Director/Trustee Two

MARK JEFFERS
VI
9430 ST LAWRENCE DRIVE
CHICAGO IL 60619

Officer/Director/Trustee Three

BRYANT JEFFERS
TREASURER
4150 DAYLILY DRIVE
OWINGS MILLS MD 21117

Officer/Director/Trustee Four

VERIAN JEFFERS
SECRETARY
7645 MORNINGSIDE WAY
SEVERN VALLEY PA 17360

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/21/2016
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family 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 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
Signature Title
Signature Date

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