FORM 1023-EZ for REFUGE 217 INC

Field Data
EIN 47-2459465
Case Number EO-2015016-000055
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name REFUGE 217 INC
Organization’s Mailing Address 2355 EAST CEDAR RIDGE ROAD
City TISHOMINGO
State OK
ZIP 73460
Accounting period End 12
Primary contact name TYSON RATZLAFF
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TYSON RATZLAFF
PRESIDENT-DIRECTOR
2355 EAST CEDAR RIDGE ROAD
TISHOMINGO OK 73460

Officer/Director/Trustee Two

JAYNE HULL
VICE PRESIDENT - DIRECTOR
2355 EAST CEDAR RIDGE ROAD
TISHOMINGO OK 73460

Officer/Director/Trustee Three

LINDSAY RATZLAFF
SEC TREAS - DIRECTOR
2355 EAST CEDAR RIDGE ROAD
TISHOMINGO OK 73460

Officer/Director/Trustee Four

LISA SHEPHERD
DIRECTOR
2355 EAST CEDAR RIDGE ROAD
TISHOMINGO OK 73460

Officer/Director/Trustee Five

TOMMY DUNCAN
DIRECTOR
2355 EAST CEDAR RIDGE ROAD
TISHOMINGO OK 73460

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/8/2014
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O20 - Youth Centers, Clubs, Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
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 No
Conducting Activities Outside of United States No
Financial transactions with officers Yes
Unrelated Gross Income $1,000 or More No
Gaming Activity No
Disaster relief assistance No
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
Signature Title
Signature Date

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