FORM 1023-EZ for COTTAGE HOSPITAL AUXILARY

Field Data
EIN 37-1793127
Case Number EO-2015302-000218
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COTTAGE HOSPITAL AUXILARY
Organization’s Mailing Address PO BOX 143
City WOODSVILLE
State NH
ZIP 03785
Accounting period End 5
Primary contact name AMY BAKER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LINDA PAIR
CO PRESIDENT
PO BOX 82
NORTH HAVERHILL NH 03774

Officer/Director/Trustee Two

MARCIA SELENT
CO PRESIDENT
16 MADISON DRIVE
WOODSVILLE NH 03785

Officer/Director/Trustee Three

LUANA WILSON-REYNOLDS
TREASURER
PO BOX 143
WOODSVILLE NH 03785

Officer/Director/Trustee Four

KAREN RAJSTETER
SECRETARY
220 WESTVIEW DRIVE
WOODSVILLE NH 03785

Officer/Director/Trustee Five

LYNN RHOADS
VICE PRESIDENT
12 BEECH STREET
WOODSVILLE NH 03785

Organization’s website
Organization’s email LINDPAIR@AOL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/2014
Organization Incorporation State NH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E11 - Single Organization Support
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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