FORM 1023-EZ for LIVING HOPE MOUNTAIN RESPITE INC

Field Data
EIN 84-4382747
Case Number EO-2020085-000248
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LIVING HOPE MOUNTAIN RESPITE INC
Organization’s Mailing Address 5676 MAIDENHEAD DRIVE
City WINDSOR
State CO
ZIP 80550
Accounting period End 12
Primary contact name KELLY PACKARD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KURT ANDERS
DIRECTOR
4906 SMALLWOOD COURT
FORT COLLINS CO 80528

Officer/Director/Trustee Two

WILLIAM HASTINGS
DIRECTOR
2825 BALMORAL COURT
FORT COLLINS CO 80525

Officer/Director/Trustee Three

ALICE SIMPSON
DIRECTOR
1981 SEDRO STREET
CUYAHOGA FALLS OH 44221

Officer/Director/Trustee Four

KELLY PACKARD
DIRECTOR
5676 MAIDENHEAD DRIVE
WINDSOR CO 80550

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/10/2020
Organization Incorporation State CO
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 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 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 KELLY PACKARD
Signature Title DIRECTOR
Signature Date 3/23/2020

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