FORM 1023-EZ for ETERNAL LIGHT FOUNDATION

Field Data
EIN 82-0839151
Case Number EO-2019157-000197
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ETERNAL LIGHT FOUNDATION
Organization’s Mailing Address 2614 OCCIDENTAL DR
City VIENNA
State VA
ZIP 22180
Accounting period End 12
Primary contact name SARAH KIM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NICOLE BAZEMORE
PRESIDENT / DIRECTOR
2614 OCCIDENTAL DR
VIENNA VA 22180

Officer/Director/Trustee Three

THOMAS CRUTCHFIELD
TREASURER / DIRECTOR
4035 RIDGETOP RD STE 550
FAIFAX VA 22030

Officer/Director/Trustee Four

BILL DUNKER
SECRETARY / DIRECTOR
800 SW 6TH AVE
CAPE CORAL FL 33991

Organization’s website ETERNALLIGHTFOUNDATION.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/16/17
Organization Incorporation State DE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A82 - Historical Preservation
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence Yes
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 NICOLE BAZEMORE
Signature Title PRESIDENT / DIRECTOR
Signature Date 6/4/19

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