FORM 1023-EZ for GROUNDED LIFE

Field Data
EIN 81-5435614
Case Number EO-2017058-000604
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GROUNDED LIFE
Organization’s Mailing Address 200 SATTERFIELD RD
City SIMPSONVILLE
State SC
ZIP 29631
Accounting period End 12
Primary contact name ZULMA PETTY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CHASTITY PETTY
EXECUTIVE DIRECTOR
200 SATTERFILED RD
SPARTANBURG SC 29301

Officer/Director/Trustee Two

ZULMA PETTY
OFFICER
416 SUMMERTON PLACE
MOORE SC 29369

Organization’s website WWW.GROUNDEDLIFE.ORG
Organization’s email CONTACT@GROUNDEDLIFE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/21/2017
Organization Incorporation State SC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
Donation of funds Yes
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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