FORM 1023-EZ for RESTORING LIVES ALLIANCE INC

Field Data
EIN 82-5508548
Case Number EO-2018213-000208
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RESTORING LIVES ALLIANCE INC
Organization’s Mailing Address 707 WHITLOCK AVENUE SW D34
City MARIETTA
State GA
ZIP 30064
Accounting period End 12
Primary contact name CHARLOTTE LOMNICKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRIAN DOUGLAS
PRESIDENT/CHAIRMAN
900 CIRCLE 75 SE SUITE 800
ATLANTA GA 30339

Officer/Director/Trustee Two

DOUGLAS CHAFFINS
TREASURER
707 WHITLOCK AVENUE SW D34
MARIETTA GA 30064

Officer/Director/Trustee Three

DELINDA GORE
OFFICER
10 EAST PARK SQUARE SUITE 350
MARIETTA GA 30090

Officer/Director/Trustee Four

KEN HARMON
OFFICER
1000 CHASTAIN ROAD
KENNESAW GA 30144

Officer/Director/Trustee Five

TERESA JOHNSON
OFFICER
1000 CHASTAIN ROAD
KENNESAW GA 30144

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/5/18
Organization Incorporation State GA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I12 - Fund Raising and/or Fund Distribution
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 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 BRIAN DOUGLAS
Signature Title PRESIDENT/CHAIRMAN
Signature Date 7/30/18

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