FORM 1023-EZ for PACS - LIFE LAB

Field Data
EIN 82-5189747
Case Number EO-2018128-000675
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PACS - LIFE LAB
Organization’s Mailing Address 3000 BARKWOOD DRIVE
City MCKINNEY
State TX
ZIP 75071-8420
Accounting period End 12
Primary contact name SHOSHANA HUBBARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHOSHANA HUBBARD
PRESIDENT
3000 BARKWOOD DRIVE
MCKINNEY TX 75071-8420

Officer/Director/Trustee Two

ANTONIO HUBBARD
VICE PRESIDENT
3000 BARKWOOD DRIVE
MCKINNEY TX 75071-8420

Officer/Director/Trustee Three

TANISHA BROWN
SECRETARY
1517 BULL STREET
AUBREY TX 76227-2917

Officer/Director/Trustee Four

SHENIQUA COLLINS
TREASURER
10229 IRONWOOD LANE
DALLAS TX 75249-1514

Officer/Director/Trustee Five

DAMIEN COLEMAN
DIRECTOR
3904 BROADMOR ROAD NW
HUNSTVILLE AL 35810

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/20/18
Organization Incorporation State TX
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: Yes
Religious: Yes
Educational: Yes
Scientific: No
Literary: Yes
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 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 SHOSHANA HUBBARD
Signature Title PRESIDENT
Signature Date 5/2/18

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