FORM 1023-EZ for EXERCISE 4 LIFE

Field Data
EIN 81-1254986
Case Number EO-2016032-000231
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name EXERCISE 4 LIFE
Organization’s Mailing Address 2156 PELHAM PARKWAY SUITE D
City PELHAM
State AL
ZIP 35124
Accounting period End 12
Primary contact name CONSTANCE KELLY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CONSTANCE KELLY
PRESIDENT
2156 PELHAM PARKWAY SUITE D
PELHAM AL 35124

Officer/Director/Trustee Two

MARIO JOHNSON
BOARD MEMBER
23 VANN DRIVE
BIRMINGHAM AL 35242

Officer/Director/Trustee Three

NICOLE CARTER
BOARD MEMBER
205 20TH STREET NORTH
BIRMINGHAM AL 35203

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/28/2016
Organization Incorporation State AL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E01 - Alliance/Advocacy Organizations
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 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
Signature Title
Signature Date

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