| Field | Data |
|---|---|
| EIN | 81-1048616 |
| Case Number | EO-2016015-000514 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | SILVERTON AND SAN JUAN CO CLINIC |
| Organization’s Mailing Address | PO BOX 964 |
| City | SILVERTON |
| State | CO |
| ZIP | 81433 |
| Accounting period End | 12 |
| Primary contact name | KIM EISNER |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
KIM EISNER
PRESIDENT
PO BOX 964
SILVERTON CO 81433
DONNA PERINO
SECRETARY
PO BOX 964
SILVERTON CO 81433
KRISTINA RHOADES
TREASURER
PO BOX 964
SILVERTON CO 81433
TERESA BROKERING
DIRECTOR
PO BOX 964
SILVERTON CO 81433
PAULETTE SCHMALTZ
DIRECTOR
PO BOX 964
SILVERTON CO 81433
| Organization’s website | N/A |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 12/31/2015 |
| Organization Incorporation State | CO |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E32 - Ambulatory Health Center, Community Clinic |
| 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 | 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 | |
| Signature Title | |
| Signature Date |
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