FORM 1023-EZ for TRANSFORMATION LIFE CHURCH

Field Data
EIN 84-4018499
Case Number EO-2020045-000372
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TRANSFORMATION LIFE CHURCH
Organization’s Mailing Address 920 LASALLE AVE
City HAMPTON
State VA
ZIP 23669
Accounting period End 12
Primary contact name JIMELL ROBERTS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JIMELL ROBERTS
PRESIDENT
3 EAST DAVIS ROAD
HAMPTON VA 23666

Officer/Director/Trustee Two

MICHAEL ALLEN
VICE PRESIDENT
355 ALLEN ROAD
BRODNAX VA 23920

Officer/Director/Trustee Three

JACQUE MOORE
SECRETARY
713 EAST FERRELL STREET
SOUTH HILL VA 23970

Officer/Director/Trustee Four

MARCUS WHITE
TREASURE
905 SUSAN COURT
HAMPTON VA 23661

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/29/2013
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: No
Religious: No
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 JIMELL ROBERTS
Signature Title PRESIDENT
Signature Date 2/12/2020

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