FORM 1023-EZ for NORTH MEDFORD CLUB INC

Field Data
EIN 43-3001793
Case Number EO-2014254-000088
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NORTH MEDFORD CLUB INC
Organization’s Mailing Address 16 VILLAGE VIEW ROAD
City WESTFORD
State MA
ZIP 01886
Accounting period End 12
Primary contact name KEN PARKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MARK FONTAINE
PRESIDENT
786 ELM STREET
LEOMINSTER MA 01453

Officer/Director/Trustee Two

DONNA LEBLANC
VICE PRESIDENT
3 ATTITASH AVE
SUTTON MA 01590

Officer/Director/Trustee Three

MARGE GLADWIN
TREASURER
16 VILLAGE VIEW ROAD
WESTFORD MA 01886

Officer/Director/Trustee Four

KEN PARKER
DIRECTOR
54 COAL KILN ROAD
PRINCETON MA 01541

Officer/Director/Trustee Five

JEFF GOULD
DIRECTOR
76 BICKFORD HILL ROAD
GARDNER MA 01440

Organization’s website NORTHMEDFORDCLUB.ORG
Organization’s email NORTHMEDFORDCLUB@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/3/1972
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N70 - Amateur Sports Competitions
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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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