FORM 1023-EZ for MUSICIANS LIFELINE INC

Field Data
EIN 27-3033615
Case Number EO-2014304-000376
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MUSICIANS LIFELINE INC
Organization’s Mailing Address 3 WHYNWOOD ROAD
City SIMSBURY
State CT
ZIP 06070
Accounting period End 12
Primary contact name JAMES WHITTEMORE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMES WHITTEMORE
PRESIDENT
3 WHYNWOOD ROAD
SIMSBURY CT 06070-3029

Officer/Director/Trustee Two

PAMELA BRODERICK
TREASURER
22 COBTAIL WAY
SIMSBURY CT 06070-2529

Officer/Director/Trustee Three

ROBERT GOTTFRIED
DIRECTOR
115 MONTCLAIR DRIVE
WEST HARTFORD CT 06107-3204

Officer/Director/Trustee Four

TIMOTHY MCDONALD
DIRECTOR
137 BUENA VISTA ROAD
WEST HARTFORD CT 06107-3204

Officer/Director/Trustee Five

GAIL REINER
SECRETARY
9 HAMILTON ROAD
EAST GRANBY CT 06026-9517

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/16/2010
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A90 - Arts Service Organizations and Activities
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 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 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
Signature Title
Signature Date

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