FORM 1023-EZ for LIFE RESTORATION INC

Field Data
EIN 32-0664425
Case Number EO-2021272-000217
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LIFE RESTORATION INC
Organization’s Mailing Address 603 COBBLESTONE BLVD
City STOCKBRIDGE
State GA
ZIP 30281
Accounting period End 12
Primary contact name GERMA LIVINGSTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GERMA LIVINGSTON
PRESIDENT
603 COBBLESTONE BLVD
STOCKBRIDGE GA 30281

Officer/Director/Trustee Two

FOLICHARD TUCKER
TREASURER
603 COBBLESTONE BLVD
STOCKBRIDGE GA 30281

Officer/Director/Trustee Three

MCCLAIR LANDSAY
SECRETARY
603 COBBLESTONE BLVD
STOCKBRIDGE GA 30281

Officer/Director/Trustee Four

ALEXANDRA LIVINGSTON
VICE PRESIDENT
603 COBBLESTONE BLVD
STOCKBRIDGE GA 30281

Organization’s website
Organization’s email LIFERESTORATIONNU@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/2/2020
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 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 GERMA LIVINGSTON
Signature Title PRESIDENT
Signature Date 9/27/2021

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