FORM 1023-EZ for VERMONT WELLNESS COLLABORATIVE INC

Field Data
EIN 85-1424387
Case Number EO-2020169-000280
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name VERMONT WELLNESS COLLABORATIVE INC
Organization’s Mailing Address 125
City BURLINGTON
State VT
ZIP 05401
Accounting period End 6
Primary contact name CYRUS PATTEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CYRUS PATTEN
PRESIDENT
125 ST PAUL ST SUITE 106
BURLINGTON VT 05401-8462

Officer/Director/Trustee Two

MATTHEW MACNEIL
DIRECTOR
125 ST PAUL ST SUITE 106
BURLINGTON VT 05401-8462

Officer/Director/Trustee Three

DIANA KEENAN
DIRECTOR
125 ST PAUL ST SUITE 106
BURLINGTON VT 05401-8462

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/14/2019
Organization Incorporation State VT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F32 - Community Mental Health Center
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 Yes
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name CYRUS PATTEN
Signature Title PRESIDENT
Signature Date 6/15/2020

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