FORM 1023-EZ for LIFE FORUM WORLD ASSICIATION

Field Data
EIN 47-4348081
Case Number EO-2015251-000301
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIFE FORUM WORLD ASSICIATION
Organization’s Mailing Address 8550 W DESERT INN RD STE 102166
City LAS VEGAS
State NV
ZIP 89117
Accounting period End 5
Primary contact name YOSHIKATSU NAKAGAWA 702-247-6021
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

YOSHIHARU SAKAI
PRESIDENT
8550 W DESERT INN RD STE 102166
LAS VEGAS NV 89117

Officer/Director/Trustee Two

KATSUYA CHO
TREASURER
8550 W DESERT INN RD STE 102166
LAS VEGAS NV 89117

Officer/Director/Trustee Three

KIYONORI EHARA
SECRETARY
8550 W DESERT INN RD STE 102166
LAS VEGAS NV 89117

Officer/Director/Trustee Four

SUMIHIRO KUYAMA
DIRECTOR
8550 W DESERT INN RD STE 102166
LAS VEGAS NV 89117

Officer/Director/Trustee Five

GENSHO HOZUMI
DIRECTOR
8550 W DESERT INN RD STE 102166
LAS VEGAS NV 89117

Organization’s website
Organization’s email LIFEFORUM@MTE.BIGLOBE.NE.JP
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/12/2015
Organization Incorporation State NV
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W02 - Management & Technical Assistance
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: Yes
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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