FORM 1023-EZ for FIT 4 LIFE OUTREACH CENTER

Field Data
EIN 47-1495984
Case Number EO-2014328-000266
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FIT 4 LIFE OUTREACH CENTER
Organization’s Mailing Address 2736 OLD UNITED STATES HIGHWAY 64
City JAMESVILLE
State NC
ZIP 27846-9664
Accounting period End 12
Primary contact name KELVIN RAY NIXON JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KELVIN NIXON JR
PRESIDENT
1263 WINDSONG DRIVE
GREENVILLE NC 27858-9750

Officer/Director/Trustee Two

SHANIQUE NIXON
VICE PRESIDENT/SECRETARY
1263 WINDSONG DRIVE
GREENVILLE NC 27858-9750

Officer/Director/Trustee Three

GERALD KEYES
TREASURER
2736 OLD US HWY 64
JAMESVILLE NC 27846-9664

Organization’s website
Organization’s email FIT4LIFEOC@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/27/2014
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
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 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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