FORM 1023-EZ for CHILDRENS CLUBFOOT COLLABORATIVE

Field Data
EIN 82-4533478
Case Number EO-2018068-000104
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHILDRENS CLUBFOOT COLLABORATIVE
Organization’s Mailing Address 131 MOSHER ROAD
City GORHAM
State ME
ZIP 4038
Accounting period End 12
Primary contact name LAUREN CUNNINGHAM
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAUREN CUNNINGHAM
SECRETARY
19 REVERE ST 4
BOSTON MA 2114

Officer/Director/Trustee Two

JORDAN CUNNINGHAM
TREASURER
131 MOSHER ROAD
GORHAM ME 4038

Officer/Director/Trustee Three

COLLEEN CUNNINGAM
VICE PRESIDENT
131 MOSHER ROAD
GORHAM ME 4038

Officer/Director/Trustee Four

JERALD CUNNINGHAM
PRESIDENT
131 MOSHER ROAD
GORHAM ME 4038

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/11/18
Organization Incorporation State ME
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code H98 - Pediatrics Research
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
Gaming Activity No
Disaster relief assistance No
One Third Support Public Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name LAUREN CUNNINGHAM
Signature Title SECRETARY
Signature Date 3/7/18

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