FORM 1023-EZ for REDEMPTION LIFE CENTER

Field Data
EIN 81-1677733
Case Number EO-2016211-000140
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name REDEMPTION LIFE CENTER
Organization’s Mailing Address PO BOX 1297
City CODY
State WY
ZIP 82414
Accounting period End 12
Primary contact name CALEB PAYNE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SANDRA FISHER
CHAIR
1302 ALGER AVE
CODY WY 82414

Officer/Director/Trustee Two

CAROLYN ANDREWS
VICE CHAIR
1002 PARK AVE
CODY WY 82414

Officer/Director/Trustee Three

DONNA LESTER
TREASURER
613 RIVER VIEW DR
CODY WY 82414

Officer/Director/Trustee Four

DONNA SULLENGER
SECRETARY
2121 WALLACE DR
CODY WY 82414

Officer/Director/Trustee Five

CALEB PAYNE
N/A
2295 PIONEER AVE APT B
CODY WY 82414

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/13/2016
Organization Incorporation State WY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X99 - Religion Related, Spiritual Development N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
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 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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