FORM 1023-EZ for RENOVATE LIFE INC

Field Data
EIN 47-3931377
Case Number EO-2016063-000222
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name RENOVATE LIFE INC
Organization’s Mailing Address 100 WEST LUCERNE CIRCLE SUITE 200
City ORLANDO
State FL
ZIP 32801
Accounting period End 12
Primary contact name ANGELA DAVIDSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ANGELA DAVIDSON
PRESIDENT
100 WEST LUCERNE CIRCLE STE 200
ORLANDO FL 32801

Officer/Director/Trustee Two

THERESA LIGHTSEY
VICE PRESIDENT
104 RINGTAIL COURT
ORLANDO FL 32828

Officer/Director/Trustee Three

ALICIA JAMES
SECRETARY
16823 STAHELIN STREET
DETROIT MI 48219

Officer/Director/Trustee Four

GWENDOLYN HUME
TREASURER
804 HAMSTER PLACE
POINCIANA FL 34759

Officer/Director/Trustee Five

RASHEED ALLEN
DIRECTOR
390 NORTH ORANGE AVE SUITE 2300
ORLANDO FL 32801

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/26/2015
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I70 - Protection Against, Prevention of Neglect, Abuse, Exploitation
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
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
Signature Title
Signature Date

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