FORM 1023-EZ for RESTORATION COUNSELING MINISTRY

Field Data
EIN 84-2079560
Case Number EO-2019169-000244
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RESTORATION COUNSELING MINISTRY
Organization’s Mailing Address PO BOX 374
City LAKE VILLAGE
State AR
ZIP 71653
Accounting period End 12
Primary contact name PATRICIA ETTESTAD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PATRICIA ETTESTAD
PRESIDENT
PO BOX 374
LAKE VILLAGE AR 71653

Officer/Director/Trustee Two

KENT ETTESTAD
DIRECTOR
PO BOX 374
LAKE VILLAGE AR 71653

Officer/Director/Trustee Three

CHRISTINA SMITH
DIRECTOR
PO BOX 374
LAKE VILLAGE AR 71653

Officer/Director/Trustee Four

JAE SMITH
DIRECTOR
PO BOX 374
LAKE VILLAGE AR 71653

Officer/Director/Trustee Five

JOSH CAMPBELL
DIRECTOR
PO BOX 374
LAKE VILLAGE AR 71653

Organization’s website
Organization’s email BEES.HAVEN@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/13/19
Organization Incorporation State AR
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: No
Religious: Yes
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 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 PATRICIA ETTESTAD
Signature Title PRESIDENT
Signature Date 6/13/19

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