FORM 1023-EZ for RIVER CREEK REFUGE

Field Data
EIN 84-3213655
Case Number EO-2019329-000591
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RIVER CREEK REFUGE
Organization’s Mailing Address 2325 PRIMM ROAD
City CHARLOTTE
State NC
ZIP 28216-8771
Accounting period End 3
Primary contact name TIFFANY PAYTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TIFFANY PAYTON
PRESIDENT
2325 PRIMM ROAD
CHARLOTTE NC 28216

Officer/Director/Trustee Two

ALEXIS GARCIA
CHAIRPERSON
713 OAK RIDGE DR
CARY NC 27519

Officer/Director/Trustee Three

CHRISTOPHER PAYTON
TREASURER
2325 PRIMM ROAD
CHARLOTTE NC 28216

Officer/Director/Trustee Four

SYLVIA ALEXANDER
OFFICER
6286 LINEBERGERRD
SHERRILLS FORD NC 28673

Organization’s website HTTPS://RIVERCREEKREFUGE.COM
Organization’s email RIVERCREEKREFUGE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/30/19
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
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 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 TIFFANY PAYTON
Signature Title PRESIDENT
Signature Date 11/22/19

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