FORM 1023-EZ for LIGHTHOUSE OUTREACH

Field Data
EIN 87-1284386
Case Number EO-2021172-000769
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LIGHTHOUSE OUTREACH
Organization’s Mailing Address 1014 RIFLE RANGE ROAD
City MOUNT PLEASANT
State SC
ZIP 29464
Accounting period End 12
Primary contact name MARY CAROLYN GONZALES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CLIFFORD SIMMONS III
DIRECTOR
1014 RIFLE RANGE ROAD
MOUNT PLEASANT SC 29464

Officer/Director/Trustee Two

MARY CAROLYN GONZALES
DIRECTOR
1105 SEA ISLAND CROSSING LANE
MOUNTPLEASANT SC 29464

Organization’s website
Organization’s email UR@LIGHTHOUSEOUTREACH21.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/18/2021
Organization Incorporation State SC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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 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 MARY CAROLYN GONZALES
Signature Title DIRECTOR
Signature Date 6/19/2021

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