FORM 1023-EZ for ENGINE OF LIFE

Field Data
EIN 85-3021120
Case Number EO-2021095-000390
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ENGINE OF LIFE
Organization’s Mailing Address 5 SUNSET BOULEVARD NORTH
City EDWARDSVILLE
State IL
ZIP 62025
Accounting period End 12
Primary contact name FRED FRANCIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

FRED FRANCIS
DIRECTOR
5 SUNSET HILLS BOULEVARD NORTH
EDWARDSVILLE IL 62025

Officer/Director/Trustee Two

VERONICA NAJERA
DIRECTOR
5 SUNSET HILLS NORTH
EDWARDSVILLE IL 62025

Officer/Director/Trustee Three

BROOKE LYNCH
DIRECTOR
956 EUCALYPTUS DRIVE APT A
EL SEGUNDO CA 90245

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/20/2020
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E32 - Ambulatory Health Center, Community Clinic
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 Yes
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 FRED FRANCIS
Signature Title DIRECTOR
Signature Date 3/8/2021

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