FORM 1023-EZ for PREEMINENT LIFE COMMUNITY SERVICESINC

Field Data
EIN 82-4939546
Case Number EO-2018204-000239
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PREEMINENT LIFE COMMUNITY SERVICESINC
Organization’s Mailing Address 5941 TIGER LILY LANE SUITE 201
City RICHMOND
State VA
ZIP 23223
Accounting period End 12
Primary contact name ROBERT N ANDREWS II
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MCCOY EATON
CHAIRMAN, BOARD OF DIRECTORS
5941 TIGER LILY LANE SUITE 201
RICHMOND VA 23223

Officer/Director/Trustee Two

MILDRED CARROLL
SECRETARY, BOARD OF DIRECTORS
1425 TALBERT DRIVE
RICHMOND VA 23224

Officer/Director/Trustee Three

MICHAEL GENTILINI
TREASURER, BOARD OF DIRECTORS
7410 AMESBURY CIRCLE
MECHANICSVILLE VA 23111

Officer/Director/Trustee Four

RILEY CHANDLER
BOARD MEMBER
7157 PEACH ORCHARD LANE
MECHANICSVILLE VA 23111

Officer/Director/Trustee Five

CRYSTAL LEE
BOARD MEMBER
8005 DIAMOND RIDGE COURT
HENRICO VA 23231

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/23/18
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S80 - Community Service Clubs
Organization’s purpose Charitable: Yes
Religious: No
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MCCOY EATON
Signature Title CHAIRMAN, BOARD OF DIRECTORS
Signature Date 7/19/18
EIN 82-4939546
Case Number EO-2018204-000239
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PREEMINENT LIFE COMMUNITY SERVICES INC
Organization’s Mailing Address 5941 TIGER LILY LANE SUITE 201
City RICHMOND
State VA
ZIP 23223
Accounting period End 12
Primary contact name ROBERT N ANDREWS II
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MCCOY EATON
CHAIRMAN, BOARD OF DIRECTORS
5941 TIGER LILY LANE SUITE 201
RICHMOND VA 23223

Officer/Director/Trustee Two

MILDRED CARROLL
SECRETARY, BOARD OF DIRECTORS
1425 TALBERT DRIVE
RICHMOND VA 23224

Officer/Director/Trustee Three

MICHAEL GENTILINI
TREASURER, BOARD OF DIRECTORS
7410 AMESBURY CIRCLE
MECHANICSVILLE VA 23111

Officer/Director/Trustee Four

RILEY CHANDLER
BOARD MEMBER
7157 PEACH ORCHARD LANE
MECHANICSVILLE VA 23111

Officer/Director/Trustee Five

CRYSTAL LEE
BOARD MEMBER
8005 DIAMOND RIDGE COURT
HENRICO VA 23231

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/23/18
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S80 - Community Service Clubs
Organization’s purpose Charitable: Yes
Religious: No
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MCCOY EATON
Signature Title CHAIRMAN, BOARD OF DIRECTORS
Signature Date 7/19/18

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