FORM 1023-EZ for LIFE CHANGERS INC

Field Data
EIN 64-0830923
Case Number EO-2015176-000355
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIFE CHANGERS INC
Organization’s Mailing Address 1095 WINDMILL ST
City GRENADA
State MS
ZIP 38901-9309
Accounting period End 12
Primary contact name BOB HALEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

WILLIAM WHITE
PRESIDENT
772 MAPLE LANE
GRENADA MS 38901-0402

Officer/Director/Trustee Two

JUDY WHITE
VICE PRESIDENT
772 MAPLE LANE
GRENADA MS 38901-0402

Officer/Director/Trustee Three

MARGARET KEETON
BOARD MEMBER
2434 FAIRWAY ST
GRENADA MS 38901-0402

Officer/Director/Trustee Four

MICHAEL AMODEO
BOARD MEMBER
2211 PEGG ST
GRENADA MS 38901-0402

Officer/Director/Trustee Five

ROBERT HALEY
DIRECTOR
1095 WINDMILL ST
GRENADA MS 38901-0402

Organization’s website
Organization’s email HALEY1095@CABLEONE.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/11/1993
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K31 - Food Banks, Food Pantries
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 Yes
One Third Support Public No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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