FORM 1023-EZ for RISE PHOENIX RISE INC

Field Data
EIN 47-4845739
Case Number EO-2015357-000118
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name RISE PHOENIX RISE INC
Organization’s Mailing Address 502 N JAMES ST
City ASHLAND
State VA
ZIP 23005
Accounting period End 8
Primary contact name TRACI JONES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TRACI JONES
PRESIDENT
502 N JAMES ST
ASHLAND VA 23005

Officer/Director/Trustee Two

SADIE JONES
VICE PRESIDENT
305 ARLINGTON ST
ASHLAND VA 23005

Officer/Director/Trustee Three

SADIE JONES
SECRETARY
305 ARLINGTON ST
ASHLAND VA 23005

Officer/Director/Trustee Four

TRAVIS MOORE
TREASURER
305 ARLINGTON ST
ASHLAND VA 23005

Officer/Director/Trustee Five

BETH MCKENZIE-MOHR
MEMBER AT -LARGE
11390 OLD MOUNTAIN RD
GLEN ALLEN VA 23060

Organization’s website WWW.RISEPHOENIXRISE.ORG
Organization’s email TRACI@RISEPHOENIXRISE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/3/2015
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F32 - Community Mental Health Center
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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