FORM 1023-EZ for LIFT 4 10

Field Data
EIN 81-1870312
Case Number EO-2016095-000413
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIFT 4 10
Organization’s Mailing Address 184 PLANTATION DRIVE
City MOORESVILLE
State NC
ZIP 28117-5820
Accounting period End 12
Primary contact name DIANNE CHIPPS BAILEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MIKE SHARP
CHAIRMAN/DIRECTOR
184 PLANTATION DRIVE
MOORESVILLE NC 28117-5820

Officer/Director/Trustee Two

MIKE KAYES
SECRETARY/DIRECTOR
12345 WILLINGDON DRIVE
HUNTERSVILLE NC 28078-5649

Officer/Director/Trustee Three

BEN KRAUSE
TREASURER/DIRECTOR
3016 EAST GEORGIA ROAD
SIMPSONVILLE NC 29681-4366

Officer/Director/Trustee Four

TERESA SHARP
DIRECTOR
184 PLANTATION DRIVE
MOORESVILLE NC 28117-5820

Officer/Director/Trustee Five

KEN LOEBER
DIRECTOR
6623 GAYWIND DRIVE
CHARLOTTE NC 28226-6902

Organization’s website WWW.LIFT410.ORG
Organization’s email COACHSHARP@AOL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/17/2016
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O99 - Youth Development N.E.C.
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 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
Signature Title
Signature Date

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