FORM 1023-EZ for EFFECTIVE LIVING INC

Field Data
EIN 47-4768441
Case Number EO-2015246-000387
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name EFFECTIVE LIVING INC
Organization’s Mailing Address 21363 ESCONDIDO WAY S
City BOCA RATON
State FL
ZIP 33433
Accounting period End 12
Primary contact name MATTHEW PUCHFERRAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

DANIEL SCOTT SALISBURY
DIRECTOR/ OFFICER
21363 ESCONDIDO WAY S
BOCA RATON FL 33433

Officer/Director/Trustee Two

NICHOLE KIRKLAND SALISBURY
DIRECTOR
21363 ESCONDIDO WAY S
BOCA RATON FL 33433

Officer/Director/Trustee Three

MATTHEW RICHARD PUCHFERRAN
DIRECTOR
20921 PINAR TRAIL
BOCA RATON FL 33433

Officer/Director/Trustee Four

DAVID BENEDICT
DIRECTOR
661 NW 66TH AVE
PLANTATION FL 33317

Officer/Director/Trustee Five

JULIUS R KELZ III
DIRECTOR
9500 AFFIRMED LANE
BOCA RATON FL 33496

Organization’s website
Organization’s email MYEFFECTIVELIFE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/26/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
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 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
Signature Title
Signature Date

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