FORM 1023-EZ for REST IN LOVE RESPITE CARE INC

Field Data
EIN 83-1721476
Case Number EO-2018305-000193
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name REST IN LOVE RESPITE CARE INC
Organization’s Mailing Address 88 COZY CORNER
City AVENEL
State NJ
ZIP 7001
Accounting period End 12
Primary contact name JOHN ADRIAN TE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN ADRIAN TE
PRESIDENT/DIRECTOR
88 COZY CORNER
AVENEL NJ 7001

Officer/Director/Trustee Two

CAROL BAGNELL
VICE-PRESIDENT/DIRECTOR
287 FAIRWAY AVENUE
BELLEVILLE NJ 7109

Officer/Director/Trustee Three

KARLEEN JOSEPH
TREASURER/DIRECTOR
212 PROSPECT AVE APT 4B
HACKENSACK NJ 7601

Officer/Director/Trustee Four

ROSANA TAMBIS TE
DIRECTOR
88 COZY CORNER
AVENEL NJ 7001

Officer/Director/Trustee Five

AYMAN MOHAMED
SECRETARY/DIRECTOR
37 BELMONT AVENUE APT 2
JERSEY CITY NJ 7304

Organization’s website
Organization’s email J.ADRIAN.TE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/18/18
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth 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 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 ADRIAN TE
Signature Title PRESIDENT/DIRECTOR
Signature Date 10/30/18

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