FORM 1023-EZ for STILL WATERS RENEWAL

Field Data
EIN 84-3566890
Case Number EO-2021279-000252
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name STILL WATERS RENEWAL
Organization’s Mailing Address 259 SUMMIT VALLEY CIRCLE
City MAUMELLE
State AR
ZIP 72113
Accounting period End 12
Primary contact name CHARLOTTE MILLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES DANIEL
PRESIDENT
143 OAK HILL CIRCLE
EL DORADO AR 71730

Officer/Director/Trustee Two

CHARLOTTE MILLER
SECRETARY
259 SUMMIT VALLEY CIRCLE
MAUMELLE AR 72113

Officer/Director/Trustee Three

JOHN JENSEN
TREASURER
443 HOLCOMB ROAD
BRANSON MO 65616

Officer/Director/Trustee Four

LISHA HENDRIX
BOARD MEMBER
756 LOMA ROAD
BEDIAS TX 77831

Officer/Director/Trustee Five

BRENT KNAPTON
BOARD MEMBER
22102 HEARTY ORANGE COURT
CYPRESS TX 77433

Organization’s website WWW.STILLWATERSRENEWAL.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/1/2019
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
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 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 CHARLOTTE MILLER
Signature Title SECRETARY
Signature Date 10/4/2021

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