FORM 1023-EZ for SOUTH VALLEY CHILD AND FAMILY CENTER

Field Data
EIN 68-0526736
Case Number EO-2017317-000351
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SOUTH VALLEY CHILD AND FAMILY CENTER
Organization’s Mailing Address 708 S 3RD ST
City HAMILTON
State MT
ZIP 59840
Accounting period End 12
Primary contact name BLAISE FAVARA MD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BLAISE FAVARA
PRESIDENT
708 S 3RD ST
HAMILTON MT 59840

Officer/Director/Trustee Two

CYNTHIA FAVARA
SECRETARY TREASURER
708 S 3R
HAM MT 59840

Officer/Director/Trustee Three

JEREMIAH FAVARA
DIRECTOR
708 S 3RD ST
HAMILTON MT 59840

Officer/Director/Trustee Four

PAT VAUGHN
DIRECTOR
708 S 3RD ST
HAMILTON MT 59840

Officer/Director/Trustee Five

PETER KULLICK
DIRECTOR
708 S 3RD ST
HAMILTON MT 59840

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/20/2003
Organization Incorporation State MT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family 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 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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