FORM 1023-EZ for FIT FOR LIFE MINISTRY INC

Field Data
EIN 47-5138377
Case Number EO-2015278-000406
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FIT FOR LIFE MINISTRY INC
Organization’s Mailing Address 4367 BARTON RD
City CLARENCE
State NY
ZIP 14031
Accounting period End 12
Primary contact name SHAWN BLAKESLEE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SHAWN BLAKESLEE
PRESIDENT
4367 BARTON RD
CLARENCE NY 14031

Officer/Director/Trustee Two

DONALD BLAKESLEE
VICE PRESIDENT
10161 LAKEVIEW AVE
CLYMER NY 14031

Officer/Director/Trustee Three

JEREMY SCHENK
BUSINESS MANAGER
10511 WESTERWALD LANE
CLARENCE NY 14031

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/8/2013
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
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 Yes
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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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