FORM 1023-EZ for REFUGE FOR RESTORATION

Field Data
EIN 81-2113983
Case Number EO-2017053-000207
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name REFUGE FOR RESTORATION
Organization’s Mailing Address 4428 185TH ROAD
City LIVE OAK
State FL
ZIP 32060
Accounting period End 6
Primary contact name DAWN DAVIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAWN DAVIS
PRESIDENT
4428 185TH RD
LIVE OAK FL 32060

Officer/Director/Trustee Two

WENDY PHILLIPS
TREASURER
1041 EASTPORT LANE
GOODE VA 24556

Officer/Director/Trustee Three

KELLY HALE
SECRETARY
11924 CR 32
LIVE OAK FL 32060

Officer/Director/Trustee Four

CARRIE SIMPSON
MEMBER
41 37TH AVE S
JACKSONVILLE BEACH FL 32250

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/6/2016
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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 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
Signature Title
Signature Date

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