FORM 1023-EZ for RESTORED LIFE FAITH BASED TRANSITIONAL LIVING

Field Data
EIN 84-3832533
Case Number EO-2020160-000182
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RESTORED LIFE FAITH BASED TRANSITIONAL LIVING
Organization’s Mailing Address 2615 POPO AGIE DR
City ROCK SPRINGS
State WY
ZIP 82901
Accounting period End 12
Primary contact name MECHELL D WILLIAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MECHELL WILLIAMS
DIRECTOR
2615 POPO AGIE DR
ROCK SPRINGS WY 82901

Officer/Director/Trustee Two

RICHARD WILLIAMS
DIRECTOR
2615 POPO AGIE DR
ROCK SPRINGS WY 82901

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/25/2020
Organization Incorporation State WY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L80 - Housing Support Services -- Other
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 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 MECHELL WILLIAMS
Signature Title DIRECTOR
Signature Date 6/4/2020

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