FORM 1023-EZ for LAZARUS GATE

Field Data
EIN 83-3159392
Case Number EO-2019081-000405
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LAZARUS GATE
Organization’s Mailing Address 3210 SOUTH GILPIN STREET
City ENGLEWOOD
State CO
ZIP 80113
Accounting period End 12
Primary contact name DANIEL P KAPSAK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOANNA HARRISON
DIRECTOR
1411 CENTAUR CIRCLE
LAFAYETTE CO 80026

Officer/Director/Trustee Two

BOBBIE KITE
DIRECTOR
2197 S UNIVERSITY BOULEVARD STE 339
DENVER CO 80208

Officer/Director/Trustee Three

MARK BELL
DIRECTOR
3210 S GILPIN STREET
ENGLEWOOD CO 80113

Officer/Director/Trustee Four

JAMES HALL
DIRECTOR
2054 N CLARKSON STREET
DENVER CO 80205

Officer/Director/Trustee Five

DEB MEYER
DIRECTOR
275 FLINT WAY
BROOMFIELD CO 80020

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/18/18
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P74 - Hospice
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 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 JOANNA HARRISON
Signature Title DIRECTOR
Signature Date 3/20/19

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