FORM 1023-EZ for RESTORATION HOUSE INC

Field Data
EIN 82-1418973
Case Number EO-2018136-000011
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name RESTORATION HOUSE INC
Organization’s Mailing Address 210 N 17TH STREET SUITE 105
City 63103
State MO
ZIP 63103
Accounting period End 12
Primary contact name MATTHEW BELZ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAUL RAMSAROOP
BOARD MEMBER
4440 LINDELL BLVD UNIT 404
SAINT LOUIS MO 63108

Officer/Director/Trustee Two

MATTHEW DOUGHERTY
TREASURER AND BOARD MEMBER
1782 PRIMROSE LANE
BARNHARDT MO 63012

Officer/Director/Trustee Three

ANDREW KISHNA
PRESIDENT AND BOARD MEMBER
1121 OLIVETTE EXECUTIVE PKWY 100
OLLIVETTE MO 63108

Officer/Director/Trustee Four

TIMOTHY NEEDHAM
CEO AND BOARD MEMBER
10800 LARKSPUR DR
SAINT LOUIS MO 63123

Organization’s website RESTORATIONHOUSESTL.ORG
Organization’s email TIM@RESTORATIONHOUSESTL.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/6/17
Organization Incorporation State MO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P85 - Homeless Persons Centers, Services
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name TIMOTHY NEEDHAM
Signature Title CEO AND BOARD MEMBER
Signature Date 5/11/18

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