FORM 1023-EZ for HOUSE OF REFUGE CHRISTAIN MINISTRIES

Field Data
EIN 84-2741665
Case Number EO-2019235-000402
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HOUSE OF REFUGE CHRISTAIN MINISTRIES
Organization’s Mailing Address 4820 VEASEY MILL DRIVE
City WADE
State NC
ZIP 28395
Accounting period End 12
Primary contact name KARINA BROUSSARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LEE BROUSSARD
PRESIDENT & EXECUTIVE DIRECTOR
4820 VEASEY MILL DRIVE
WADE NC 28395

Officer/Director/Trustee Two

KARINA BROUSSARD
VICE PRESIDENT
4820 VEASEY MILL DRIVE
WADE NC 28395

Officer/Director/Trustee Three

APRIL RAVIZEE
SECRETAY TREASUER
828 ALEXWOOD DRIVE
HOPE MILLS NC 28348

Officer/Director/Trustee Four

DAVID PICKETT
SR COMPLIANCE OFFICER
355 MCMILLY ROAD
SHALLOTTE NC 28470

Organization’s website
Organization’s email HRCMINISTRIES@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/21/19
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: No
Literary: Yes
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 LEE BROUSSARD
Signature Title PRESIDENT & EXECUTIVE DIRECTOR
Signature Date 8/21/19

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