FORM 1023-EZ for RESTORATION RANCH INC

Field Data
EIN 81-2582721
Case Number EO-2016190-000185
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name RESTORATION RANCH INC
Organization’s Mailing Address 977 POPLAR SPRINGS ROAD NW
City DALTON
State GA
ZIP 30720
Accounting period End 12
Primary contact name HOLLI BROADRICK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

HOLLI BROADRICK
DIRECTOR
977 POPLAR SPRINGS ROAD NW
DALTON GA 30720-7091

Officer/Director/Trustee Two

JOHN BROADRICK
SECRETARY/TREASURER
977 POPLAR SPRINGS ROAD NW
DALTON GA 30720-7091

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/26/2016
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E99 - Health - General and Rehabilitative N.E.C.
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 Yes
Donation of funds No
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
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
Signature Title
Signature Date

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