FORM 1023-EZ for THE REFUGE AT GRACE RANCH

Field Data
EIN 81-1107177
Case Number EO-2016020-000333
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE REFUGE AT GRACE RANCH
Organization’s Mailing Address 502 WEST MONTGOMERY 154
City WILLIS
State TX
ZIP 77378
Accounting period End 12
Primary contact name WILLIAM DOUGLAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

WILLIAM DOUGLAS
DIRECTOR/PRESIDENT
502 WEST MONTGOMERY 154
WILLIS TX 77378

Officer/Director/Trustee Two

BELINDA DOUGLAS
VICE PRESIDENT/CO-DIRECTOR
502 WEST MONTGOMERY 154
WILLIS TX 77378

Officer/Director/Trustee Three

ROXY BRUMLEY
BOARD MEMBER/OFFICER
PO BOX 1542
MONTGOMERY TX 77356

Officer/Director/Trustee Four

PENNY JUSTMANN
BOARD MEMBER/OFFICER
11232 TRIPLECROWN WAY
CONROE TX 77304

Officer/Director/Trustee Five

KARI PERKINS
BOARD MEMBER/OFFICER
PO BOX 1542
MONTGOMERY TX 77356

Organization’s website
Organization’s email THEREFUGEATGRACERANCH@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/13/2016
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P43 - Family Violence Shelters, Services
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
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 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
Signature Title
Signature Date

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