FORM 1023-EZ for KINGDOM LIFE PEORIA

Field Data
EIN 84-2981773
Case Number EO-2019339-000520
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KINGDOM LIFE PEORIA
Organization’s Mailing Address 4507 N STERLING AVE SUITE 208 G
City PEORIA
State IL
ZIP 61615-3860
Accounting period End 9
Primary contact name ROBBY WILSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBBY WILSON
EXECUTIVE DIRECTOR
2224 W FORREST HILL AVE
PEORIA IL 61604-1968

Officer/Director/Trustee Two

PATRICK ROGERS
PRESIDENT
4010 N BRANDYWINE DR
PEORIA IL 61614-6826

Officer/Director/Trustee Three

MARK BIXLER
VICE PRESIDENT
603 E PINE ST
CANTON IL 61520-2854

Officer/Director/Trustee Four

BRANDON MOOBERRY
RECORDING SECRETARY
10927 W SMITHVILLE RD
HANNA CITY IL 61536

Organization’s website WWW.KINGDOMLIFEPEORIA.COM
Organization’s email KINGDOMLIFEPEORIA@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/4/19
Organization Incorporation State IL
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: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee Yes
Donation of funds Yes
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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ROBBY WILSON
Signature Title EXECUTIVE DIRECTOR
Signature Date 12/3/19

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