FORM 1023-EZ for REVIVAL COUNSELING

Field Data
EIN 82-5520039
Case Number EO-2018141-000324
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name REVIVAL COUNSELING
Organization’s Mailing Address PO BOX 406
City STRASBURG
State CO
ZIP 80136
Accounting period End 12
Primary contact name TANYA GOBLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TANYA GOBLE
PRESIDENT
7385 W HIGHWAY 50
SALIDA CO 81201

Officer/Director/Trustee Two

JOSEPH BECHTOL
TREASURER
7385 W HIGHWAY 50
SALIDA CO 81201

Officer/Director/Trustee Three

MARLA MADRID
SECRETARY
7385 W HIGHWAY 50
SALIDA CO 81201

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/8/18
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
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 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 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 TANYA GOBLE
Signature Title PRESIDENT
Signature Date 5/17/18

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