FORM 1023-EZ for JESUS HOUSE RESTORATION MINISTRIES

Field Data
EIN 82-4280648
Case Number EO-2018171-000575
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JESUS HOUSE RESTORATION MINISTRIES
Organization’s Mailing Address C/O TOM YAXLEY 2918 RUTHERFORD DRIV
City URBANA
State IL
ZIP 61802
Accounting period End 6
Primary contact name TOM YAXLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DUSTIN BROWN
EXECUTIVE DIRECTOR
822 NORTH DIVISION
URBANA IL 61801

Officer/Director/Trustee Two

THOMAS YAXLEY
TREASURER, SECRETARY
2918 RUTHERFORD DR
URBANA IL 61802

Officer/Director/Trustee Three

CASEY WILLIAMS
BOARD MEMBER
1550 SOUTH POINT DR
RANTOUL IL 61866

Officer/Director/Trustee Four

BRIDGETT SCHOTT
BOARD MEMBER
1405 HARRINGTON DR
CHAMPAIGN IL 61821

Officer/Director/Trustee Five

ETHAN DURST
BOARD MEMBER
504 GH BAKER DR
URBANA IL 61801

Organization’s website JESUSHOUSERECOVERY.COM
Organization’s email TYAXLEY@YGFINANCIAL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/29/18
Organization Incorporation State IL
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 Yes
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 THOMAS YAXLEY
Signature Title TREASURER, SECRETARY
Signature Date 6/18/18

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