FORM 1023-EZ for REFUGE RECOVERY SOUTHEAST REGION VII

Field Data
EIN 82-5207775
Case Number EO-2019029-000357
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name REFUGE RECOVERY SOUTHEAST REGION VII
Organization’s Mailing Address 1340 NW 5TH AVE
City FT LAUDERDALE
State FL
ZIP 33311
Accounting period End 12
Primary contact name DONALD R WESTERVELT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DONALD WESTERVELT
SECRETARY
1240 NW 5TH AVE
FT LAUDERDALE FL 33311

Officer/Director/Trustee Two

DONALD WESTERVELT
SECRETARY
1340 NW 5TH AVE
FT LAUDERDALE FL 33311

Officer/Director/Trustee Three

DANIEL FISHBURN
CHAIR
700 S SKYLARK DR UNIT 301
ASHEVILLE NC 28801

Officer/Director/Trustee Four

BRENT BORRESSON
TREASURER
201 W 5TH AVE UNIT 4
KNOXVILLE TN 37917

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/18
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F20 - Alcohol, Drug and Substance Abuse, Dependency Prevention and Treatment
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 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 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 DONALD WESTERVELT
Signature Title SECRETARY
Signature Date 12/17/18

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