FORM 1023-EZ for FOUNTAIN OF RENEWAL

Field Data
EIN 82-3153475
Case Number EO-2018022-000296
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name FOUNTAIN OF RENEWAL
Organization’s Mailing Address 503 PINEHILL RD
City MONTGOMERY
State AL
ZIP 36109
Accounting period End 12
Primary contact name MARLEBNE ROBINSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CAROLYN HARRIS
OFFICER
503 PINEHILL RD
MONTGOMERY AL 36109

Officer/Director/Trustee Two

GEORGIANN BYERS
OFFICER
104 IVEYBRIDGE COURT
PIKE ROAD AL 36064

Officer/Director/Trustee Three

RAY BYERS
OFFICER
1048 IVEY BRIDGE
PIKE ROAD AL 36064

Officer/Director/Trustee Four

JAMES PITTS
OFFICER
3059 BILTMORE AVE
MONTGOMERY AL 36109

Officer/Director/Trustee Five

JOLEEN KARR
OFFICER
648 CLARKS LANDING ROAD
AUTAUGAVILLE AL 36003

Organization’s website THEFOUNTAINHOUSE.NET
Organization’s email FOUNTAINOFRENEWAL@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/12/17
Organization Incorporation State AL
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement Yes
Correctness Declaration Yes
Signature Name JAMES PITTS
Signature Title OFFICER
Signature Date 1/19/18

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