FORM 1023-EZ for BELHAVEN RENAISSANCE

Field Data
EIN 47-3689964
Case Number EO-2015105-000307
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BELHAVEN RENAISSANCE
Organization’s Mailing Address 338 EDWARD STREET
City BELHAVEN
State NC
ZIP 27810
Accounting period End 12
Primary contact name KAREN WAHAB
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KAREN WAHAB
CHIEF OPERATING OFFICER
338 EDWARD STREET
BELHAVEN NC 27810

Officer/Director/Trustee Two

YVONNE DERUIZ
FINANCIAL OFFICER
338 EDWARD STREET
BELHAVEN NC 27810

Officer/Director/Trustee Three

CORKI LEVERETT
CHAIRMAN OF BOARD
338 EDWARD STREET
BELHAVEN NC 27810

Officer/Director/Trustee Four

JULIAN GOFF
BOARD MEMBER
338 EDWARD STREET
BELHAVEN NC 27810

Officer/Director/Trustee Five

MISA RAYNOR
BOARD MEMBER
338 EDWARD STREET
BELHAVEN NC 27810

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/10/2015
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S20 - Community, Neighborhood Development, Improvement (General)
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 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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