FORM 1023-EZ for YANKEE PATIENT ASSISTANCE FUND

Field Data
EIN 46-2047748
Case Number EO-2017068-000408
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name YANKEE PATIENT ASSISTANCE FUND
Organization’s Mailing Address 115 WILDWOOD ST
City GREENFIELD
State MA
ZIP 01301
Accounting period End 12
Primary contact name JEFFREY BLOMSTEDT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEFFREY BLOMSTEDT
PRESIDENT, TREASURER
115 WILDWOOD ST
GREENFIELD MA 01301-1215

Officer/Director/Trustee Two

MICHAEL PLAGER
VICE PRESIDENT
115 WILDWOOD ST
GREENFIELD MA 01301-1215

Officer/Director/Trustee Three

DEBRA HAYES
CLERK
115 WILDWOOD ST
GREENFIELD MA 01301-1215

Officer/Director/Trustee Four

JULIE FORSLEY
DIRECTOR
115 WILDWOOD ST
GREENFIELD MA 01301-1215

Organization’s website
Organization’s email LABLOM@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/15/2013
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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