FORM 1023-EZ for WILDERNESS REFUGE RECOVERY MINISTRIES

Field Data
EIN 83-1765799
Case Number EO-2018274-000137
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name WILDERNESS REFUGE RECOVERY MINISTRIES
Organization’s Mailing Address 406 BRYANT ST
City PETAL
State MS
ZIP 39465
Accounting period End 12
Primary contact name PATRICK EZELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICK EZELL
EXECUTIVE DIRECTOR
406 BRYANT ST
PETAL MS 39465

Officer/Director/Trustee Two

HEATHER EZELL
ASSOCIATE DIRECTOR
406 BRYANT ST
PETAL MS 39465

Officer/Director/Trustee Three

LAUREN TRUSSELL
TREASURER
143 LUTHER CARTER RD
PETAL MS 39465

Officer/Director/Trustee Four

WILLIAM PIERCE
OFFICER
237 WILDWOOD TRL
PETAL MS 39465

Officer/Director/Trustee Five

MATTHEW SHEPHERD
OFFICER
25 CHANDLER
PETAL MS 39465

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/16/18
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F33 - Group Home, Residential Treatment Facility - Mental Health Related
Organization’s purpose Charitable: No
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 Yes
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 PATRICK EZELL
Signature Title EXECUTIVE DIRECTOR
Signature Date 9/27/18

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