FORM 1023-EZ for LIFE RENEWAL NETWORK

Field Data
EIN 81-4045477
Case Number EO-2016285-000263
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LIFE RENEWAL NETWORK
Organization’s Mailing Address 33634 W 8 MILE RD
City FARMINGTON HILLS
State MI
ZIP 48335
Accounting period End 12
Primary contact name MARK FAERBER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TIMOTHY BROE
PRESIDENT
33634 W 8 MILE RD
FAMINGTON HILLS MI 48335

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/4/2016
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F60 - Counseling, Support Groups
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 Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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
Signature Title
Signature Date

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