FORM 1023-EZ for ROOM TO RENEW

Field Data
EIN 81-4506203
Case Number EO-2016333-000184
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ROOM TO RENEW
Organization’s Mailing Address 235 TRAVIS ST NE
City GRAND RAPIDS
State MI
ZIP 49505
Accounting period End 12
Primary contact name REBECCA S FISH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEIDRE REMTEMA
PRESIDENT
235 TRAVIS ST NE
GRAND RAPIDS MI 49509-4725

Officer/Director/Trustee Two

MARK LACROIX
VICE PRESIDENT / TREASURER
7551 FASE ST
ADA MI 49301-9025

Officer/Director/Trustee Three

LORELEI MOORE
SECRETARY
1542 ROBINSON RD SE
GRAND RAPIDS MI 49506-1748

Organization’s website
Organization’s email DEIDRE@DEIDREINTERIORS.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/21/2016
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
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 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 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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