FORM 1023-EZ for TC LIFE RESTORATION CENTER

Field Data
EIN 86-2182529
Case Number EO-2021091-000845
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TC LIFE RESTORATION CENTER
Organization’s Mailing Address 7808 NW MORROCCO DRIVE
City LAWTON
State OK
ZIP 73505
Accounting period End 12
Primary contact name MICHAEL COZART
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DEVON JENKINS
PRESIDENT/CEO
7808 NW MORROCCOO DRIVE
LAWTON OK 73505

Officer/Director/Trustee Two

SHAWN BROWN
SECRETARY
7808 NW MORROCCOO DRIVE
LAWTON OK 73505

Officer/Director/Trustee Three

TIFFANY NEWTON
TREASURER
7808 NW MORROCCOO DRIVE
LAWTON OK 73505

Organization’s website
Organization’s email DEVONJJENKINS@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/9/2021
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O99 - Youth Development N.E.C.
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 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 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 DEVON JENKINS
Signature Title PRESIDENT/CEO
Signature Date 2/22/2021

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