FORM 1023-EZ for REVITALIZ3 INC
| Field | Data |
|---|---|
| EIN | 86-3810287 |
| Case Number | EO-2021193-001115 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | REVITALIZ3 INC |
| Organization’s Mailing Address | 19201 SONOMA HWY SUITE 258 |
| City | SONOMA |
| State | CA |
| ZIP | 95476 |
| Accounting period End | 12 |
| Primary contact name | KENYATTA JACKSON |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
KENYATTA JACKSON
CHIEF EXECUTIVE OFFICER
19201 SONOMA HWY SUITE 258
SONOMA CA 95476
Officer/Director/Trustee Two
CLAY JACKSON
CHIEF FINANCIAL OFFICER
19201 SONOMA HWY SUITE 258
SONOMA CA 95476
Officer/Director/Trustee Three
SADE MORGAN WESLEY
SECRETARY
19201 SONOMA HWY SUITE 258
SONOMA CA 95476
| Organization’s website | |
|---|---|
| Organization’s email | REVITALIZ3.INFO@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 5/12/2021 |
| Organization Incorporation State | CA |
| 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 | KENYATTA JACKSON |
| Signature Title | CHIEF EXECUTIVE OFFICER |
| Signature Date | 7/11/2021 |
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