FORM 1023-EZ for A NEW BEGINNING INC A NON PROFIT CORPORATION

Field Data
EIN 81-3218217
Case Number EO-2016295-000231
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name A NEW BEGINNING INC A NON PROFIT CORPORATION
Organization’s Mailing Address 2420 18TH ST
City BETTENDORF
State IA
ZIP 52722
Accounting period End 6
Primary contact name TIM PRINTY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TIM PRINTY
CEO
17552 N 2550 AVE
GENESEO IL 61254-2131

Officer/Director/Trustee Two

KRISTINE DEIDIKER
CFO
17552 N 2550 AVE
GENESEO IL 61254-1743

Officer/Director/Trustee Three

JACOB IRISH
COO
410 E MAIN ST
BIGGSVILLE IL 61418-0001

Officer/Director/Trustee Four

KYLE RETZLAFF
EVP
22296 N 1551TH AVE
ATKINSON IL 61235-0001

Officer/Director/Trustee Five

TRISTAN PRINTY
ACTIVITIES DIRECTOR
17552 N 2550 AVE
GENESEO IL 61254-2131

Organization’s website WWW.ANBNONPROFIT.COM
Organization’s email TIM.PRINTY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/12/2016
Organization Incorporation State IA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F99 - Mental Health, Crisis Intervention 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
Signature Title
Signature Date

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