FORM 1023-EZ for CHARITY PLUS LIFE

Field Data
EIN 47-3698990
Case Number EO-2015212-000545
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHARITY PLUS LIFE
Organization’s Mailing Address 3500 GUNSTON ROAD
City ALEXANDRIA
State VA
ZIP 22302-2135
Accounting period End 12
Primary contact name SUSAN LEAHY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ANDREA RODGERS
DIRECTOR AND PRESIDENT
3500 GUNSTON ROAD
ALEXANDRIA VA 22302-2135

Officer/Director/Trustee Two

AGAAT DEN HERTOG
DIRECTOR AND TREASURER
402 FAIRWAY DRIVE
SHELBY NC 28150

Officer/Director/Trustee Three

SOPHIE MILAM
DIRECTOR AND SECRETARY
1324 N BOSWORTH AVENUE APT 2R
CHICAGO IL 60642

Organization’s website
Organization’s email ANDREA@CHARITYANDLIFE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/25/2015
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
Literary: Yes
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 Yes
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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