FORM 1023-EZ for FOUNTAIN OF LIFE INTERNATIONAL MINISTRIES INC

Field Data
EIN 83-3372655
Case Number EO-2019050-000125
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FOUNTAIN OF LIFE INTERNATIONAL MINISTRIES INC
Organization’s Mailing Address 1551 E53RD STREET
City BROOKLYN
State NY
ZIP 11234
Accounting period End 12
Primary contact name PAULINE MOSS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAULINE MOSS
PRESIDENT/CEO
1551 E53RD STREET
BROOKLYN NY 11234

Officer/Director/Trustee Two

JOANNA SALOMON
TREASURER/SECRETARY
4419 ROCKAWAY BEACH BLVD
FAR ROCKAWAY NY 11691

Officer/Director/Trustee Three

JOHN MOSS
VICE PRESIDENT
1551 E53RD STREET
BROOKLYN NY 11234

Officer/Director/Trustee Four

CYNTHIA DOUGLAS
BOARD MEMBER
6 HEMINGWAY LANE
COLUMBUS NJ 8022

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/12/19
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: Yes
Religious: Yes
Educational: Yes
Scientific: No
Literary: No
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 Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance Yes
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 PAULINE MOSS
Signature Title PRESIDENT/CEO
Signature Date 2/14/19

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