FORM 1023-EZ for REFUGE FOR THE BROKEN
| Field | Data |
|---|---|
| EIN | 85-3642668 |
| Case Number | EO-2021223-000278 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | REFUGE FOR THE BROKEN |
| Organization’s Mailing Address | 8832 BRENNAN CIRCLE APT 208 |
| City | TAMPA |
| State | FL |
| ZIP | 33615 |
| Accounting period End | 12 |
| Primary contact name | ASHLEY COVERLY |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
ASHLEY COVERLY
DIRECTOR
8832 BRENNAN CIR APT 208
TAMPA FL 33615
Officer/Director/Trustee Two
KATIE PETERSON
TREASURER
8832 BRENNAN CIRCLE APT 208
TAMPA FL 33615
Officer/Director/Trustee Three
MELONY FRIZZELL
SECRETARY
4785 BALLANTRAE BLVD
LAND O LAKES FL 34638
| Organization’s website | REFUGEFORTHEBROKEN.ORG |
|---|---|
| Organization’s email | REFUGEFORTHEBROKEN@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/27/2020 |
| Organization Incorporation State | FL |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | X01 - Alliance/Advocacy Organizations |
| Organization’s purpose | Charitable: Yes Religious: Yes 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 | 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 | ASHLEY COVERLY |
| Signature Title | DIRECTOR |
| Signature Date | 8/9/2021 |
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