FORM 1023-EZ for RE-JUVIE-NATION

Field Data
EIN 46-3205725
Case Number EO-2015082-000367
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name RE-JUVIE-NATION
Organization’s Mailing Address 29193 NORTHWESTERN HWY SUITE 589
City SOUTHFIELD
State MI
ZIP 48034
Accounting period End 12
Primary contact name RICHELLE LESTER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RICHELLE LESTER
PRESIDENT
26080 W 12 MILE RD APT C 16
SOUTHFIELD MI 48034

Officer/Director/Trustee Two

FELISA GOLDSMITH
SECRETARY
14611 WARWICK
DETROIT MI 48223

Officer/Director/Trustee Three

STEVEN FINN
TREASURER
792 AMBERLY DRIVE UNIT A
WATERFORD MI 48328

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/15/2013
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L41 - Homeless, Temporary Shelter For
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 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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