FORM 1023-EZ for BREATH OF LIFE INC

Field Data
EIN 47-2615342
Case Number EO-2015002-000206
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BREATH OF LIFE INC
Organization’s Mailing Address 27720 OLD COLONY
City FARMINGTON HILLS
State MI
ZIP 48334
Accounting period End 12
Primary contact name TIMOTHY E HARDEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ENRIQUE OSTREA
DR
27720 OLD COLONY
FARMINGTON HILLS MI 48334

Officer/Director/Trustee Two

DANILO ONATE
MR
27720 OLD COLONY
FARMINGTON HILLS MI 48334

Officer/Director/Trustee Three

PHILIP CRUZ
DR
27720 OLD COLONY
FARMINGTON HILLS MI 48334

Officer/Director/Trustee Four

DENISE VANDENHURK
MRS
27720 OLD COLONY
FARMINGTON HILLS MI 48334

Officer/Director/Trustee Five

EUGENE ESGUERRA
MR
27720 OLD COLONY
FARMINGTON HILLS MI 48334

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/19/2014
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: Yes
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 Yes
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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