FORM 1023-EZ for PHOENIX RESTORATION CENTER

Field Data
EIN 84-4508887
Case Number EO-2020059-000209
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PHOENIX RESTORATION CENTER
Organization’s Mailing Address 106 CAMELIA WAY
City JACKSON
State MS
ZIP 39047
Accounting period End 12
Primary contact name CHARLOTTE ALLEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JUSTUS LEWIS
PRESIDENT
244 RED SOX LANE
MEMPHIS TN 38105

Officer/Director/Trustee Two

MARY CARSON
SECRETARY
103 NORRIS STREET
FLORA MS 39071

Officer/Director/Trustee Three

JERRY SMITH JR
TREASURY
PO BOX 97011
PEAR MS 39288

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/17/2020
Organization Incorporation State MS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P50 - Personal Social 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 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 JUSTUS LEWIS
Signature Title PRESIDENT
Signature Date 2/26/2020

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