FORM 1023-EZ for COMMUNITY LIFELINE MINISTRIES INC

Field Data
EIN 47-1646708
Case Number EO-2014287-000385
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COMMUNITY LIFELINE MINISTRIES INC
Organization’s Mailing Address 156 S JOLIET STREET
City JOLIET
State IL
ZIP 60436-1734
Accounting period End 12
Primary contact name LOU ANN JOHNSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LOU ANN JOHNSON
PRESIDENT-DIRECTOR
156 S JOLIET ST
JOLIET IL 60436-1734

Officer/Director/Trustee Two

MARILYN DIXON
TREASURER
156 S JOLIET STREET
JOLIET IL 60436-1734

Officer/Director/Trustee Three

EDITH FAIRLEY
SECRETARY
156 S JOLIET STREET
JOLIET IL 60436-1734

Officer/Director/Trustee Four

LARRY TYLER
DIRECTOR
156 S JOLIET STREET
JOLIET IL 60436-1734

Officer/Director/Trustee Five

JOHN BECKLEY
DIRECTOR
156 S JOLIET STREET
JOLIET IL 60436-1734

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/16/2014
Organization Incorporation State IL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 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
Signature Title
Signature Date

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