FORM 1023-EZ for REVIVAL HUB

Field Data
EIN 84-3608101
Case Number EO-2019312-000215
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name REVIVAL HUB
Organization’s Mailing Address 1700 E HIGH ST
City BRYAN
State OH
ZIP 43557
Accounting period End 12
Primary contact name PETER GARZA JR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PETER GARZA JR
PRESIDENT
1700 E HIGH ST
BRYAN OH 43557

Officer/Director/Trustee Two

HEATHER BRAATEN
SECRETARY
16648 N BOULDER DR
FOUNTAIN HILLS AZ 85268

Officer/Director/Trustee Three

MICHAEL FRENCH
TREASURER
3700 BAINBRIDGE TRACE DR
IRON DALE AL 35201

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/6/19
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name PETER GARZA JR
Signature Title PRESIDENT
Signature Date 11/6/19

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