FORM 1023-EZ for BLUE CROSS YOUTH CENTER

Field Data
EIN 45-3039206
Case Number EO-2020050-000156
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLUE CROSS YOUTH CENTER
Organization’s Mailing Address 4895 BENOCH ROAD
City LAGRANGE
State ME
ZIP 04453
Accounting period End 12
Primary contact name HELEN KNEELAND
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TRACEY HOLLER
PRESIDENT
PO BOX 57
CHARLESTON ME 04422

Officer/Director/Trustee Two

HELEN KNEELAND
TREASURER
190 MAIN RD APT 1
CHARLESTON ME 04422

Officer/Director/Trustee Three

MARVIN WHEELER
DIRECTOR
86 BEANS MILL RD
CORINTH ME 04427

Officer/Director/Trustee Four

SELDEN WHEELER
DIRECTOR
9 MORISON AVE
CORINTH ME 04427

Officer/Director/Trustee Five

JASON HOLLER
DIRECTOR
PO BOX 57
CHARLESTON ME 04422

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/8/2011
Organization Incorporation State ME
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
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 HELEN KNEELAND
Signature Title TREASURER
Signature Date 2/14/2020

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