FORM 1023-EZ for LIFT UP BY COMMUNITY ACTION LUCA

Field Data
EIN 86-1857919
Case Number EO-2021132-000221
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LIFT UP BY COMMUNITY ACTION LUCA
Organization’s Mailing Address 1718 SYLVAN WAY UNIT 907
City LODI
State CA
ZIP 95242
Accounting period End 6
Primary contact name MICHELLE BLEKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TEDNA ARTHUR
SECRETARY
1718 SYLVAN WAY UNIT 907
LODI CA 95242

Officer/Director/Trustee Two

MICHELLE BLEKE
CHAIR AND DIRECTOR
1718 SYLVAN WAY UNIT 907
LODI CA 95242

Officer/Director/Trustee Three

SHANISHA JANUARY
TREASURER
1718 SYLVAN WAY UNIT 907
LODI CA 95242

Organization’s website LUCAINC.ORG
Organization’s email LUCAINC.ORG@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/13/2021
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P02 - Management & Technical Assistance
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 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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MICHELLE BLEKE
Signature Title CHAIR AND DIRECTOR
Signature Date 5/10/2021

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