FORM 1023-EZ for IMPACT LIFE

Field Data
EIN 84-2185196
Case Number EO-2019186-000119
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name IMPACT LIFE
Organization’s Mailing Address 400 LOCUST STREET SUITE 820
City DES MOINES
State IA
ZIP 50309
Accounting period End 12
Primary contact name DONNA PRICE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KENT KALMEY
PRESIDENT, DIRECTOR
11309 SPRING HOLLOW CT
PROSPECT KY 40059

Officer/Director/Trustee Two

TINA REED
SECRETARY, DIRECTOR
11121 SEWELL DR
LOUISVILLE KY 40291

Officer/Director/Trustee Three

DONNA PRICE
TREASURER, DIRECTOR
400 LOCUST STREET SUITE 820
DES MOINES IA 50309

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/12/19
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P60 - Emergency Assistance (Food, Clothing, Cash)
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 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 Yes
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DONNA PRICE
Signature Title TREASURER, DIRECTOR
Signature Date 7/2/19

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