FORM 1023-EZ for LINEAGE FOUNDATION INC

Field Data
EIN 81-4250825
Case Number EO-2016330-000360
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LINEAGE FOUNDATION INC
Organization’s Mailing Address 1629 CROSS BEAM DR
City CHARLOTTE
State NC
ZIP 28217
Accounting period End 12
Primary contact name DAVID M HILLERY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RICHARD WILLIAMS
PRESIDENT
2116 PONDMEADE LN
MATTHEWS NY 28104

Officer/Director/Trustee Two

DAVID HILLERY
TREASURER
6152 BRIDLEWOOD DR S
EAST AMHERST NY 14051

Officer/Director/Trustee Three

ANDRIA RUSS
SECRETARY
15121 TAYLOR RIDGE LN
CHARLOTTE NC 28273

Organization’s website
Organization’s email DHILLERY@TRUSTLINEAGE.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/4/2016
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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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