FORM 1023-EZ for LIFEWELL MINISTRIES INC

Field Data
EIN 84-2213333
Case Number EO-2020034-000215
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LIFEWELL MINISTRIES INC
Organization’s Mailing Address 1350 SCENIC HWY N
City SNELLVILLE
State GA
ZIP 30078-7924
Accounting period End 12
Primary contact name ROBERT BARTOLDUS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBERT BARTOLDUS
CEO
3945 BUTLER SPRINGS DRIVE
LOGANVILLE GA 30052

Officer/Director/Trustee Two

JILL BUICE
SECRETARY
3945 BUTLER SPRINGS DRIVE
LOGANVILLE GA 30052

Officer/Director/Trustee Three

BEAU HENDERSON
CFO
117 BRADFORD STREET NW
GAINESVILLE GA 30501

Organization’s website WWW.LIFEWELLMINISTRIES.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/26/2019
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 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 ROBERT BARTOLDUS
Signature Title CEO
Signature Date 1/30/2020

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