FORM 1023-EZ for IMAGE 4 LIFES

Field Data
EIN 83-0659756
Case Number EO-2018150-000312
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name IMAGE 4 LIFES
Organization’s Mailing Address 2018 MEEK AVENUE
City DES MOINES
State IA
ZIP 50311
Accounting period End 12
Primary contact name ROBERT LEE PATE JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBERT PATE
PRESIDENT
2018 MEEK AVENUE
DES MOINES IA 50311

Officer/Director/Trustee Two

ROD BRADLEY
DIRECTOR
2018 MEEK AVENUE
DES MOINES IA 50311

Officer/Director/Trustee Three

KEN SILVER
SECRETARY
2018 MEEK AVENUE
DES MOINES IA 50311

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/24/18
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O55 - Youth Development - Religious Leadership
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 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 ROBERT PATE
Signature Title PRESIDENT
Signature Date 5/25/18

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