FORM 1023-EZ for CELLFICIENT LIFE

Field Data
EIN 82-0952137
Case Number EO-2017095-000312
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CELLFICIENT LIFE
Organization’s Mailing Address PO BOX 29439
City INDIANAPOLIS
State IL
ZIP 46229
Accounting period End 3
Primary contact name JANECE WALKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JANECE WALKER
CEO
11544 STOEPPELWERTH DRIVE
INDIANAPOLIS IN 46229

Officer/Director/Trustee Two

JESSICA OWENS
TREASURER
3721 E 39TH STREET
INDIANAPOLIS IN 46205

Officer/Director/Trustee Three

TAMIKA BEELER
SECRETARY
10722 TANBARK DRIVE
INDIANAPOLIS IN 46225

Officer/Director/Trustee Four

ANTOINETTE WADE
PRESIDENT
PO BOX 29439
INDIANAPOLIS IN 46229

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/22/2017
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
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 Yes
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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