FORM 1023-EZ for LIVING WATERS CENTER FOR RESTORATION INC

Field Data
EIN 82-4804698
Case Number EO-2018254-000143
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name LIVING WATERS CENTER FOR RESTORATION INC
Organization’s Mailing Address 5358 HWY 5
City DOUGLASVILLE
State GA
ZIP 30135
Accounting period End 12
Primary contact name JOHN JONES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

THAEDRA MERCADEL
CEO
8081 CYPRESS COURT
VILLA RICA GA 30180

Officer/Director/Trustee Two

JOHN JONES
SEC & TRES & CFO
8081 CYPRESS COURT
VILLA RICA GA 30180

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/12/18
Organization Incorporation State GA
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: Yes
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 No
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 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 JOHN JONES
Signature Title SEC & TRES & CFO
Signature Date 9/9/18

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