| Field | Data |
|---|---|
| EIN | 84-2618894 |
| Case Number | EO-2019221-000195 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | LAKELAND COMMUNITY HOSPITAL FOUNDATION |
| Organization’s Mailing Address | 42024 HIGHWAY 195 |
| City | HALEYVILLE |
| State | AL |
| ZIP | 35565 |
| Accounting period End | 12 |
| Primary contact name | BAPPA MUKHERJI |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
GERITA RYE
DIRECTOR OF SERVICES
42024 HIGHWAY 195
HALEYVILLE AL 35565
DONNA JONES
DIRECTOR
706 35TH STREET
HALEYVILLE AL 35565
SHIRLEY SUDDARTH
DIRECTOR
29088 HIGHWAY 278
ADDISON AL 35540
JEFF STOKES
DIRECTOR
1705 COUNTY ROAD 351
LYNN AL 35575
MARCIA POSEY
DIRECTOR
PO BOX 883
DOUBLE SPRINGS AL 35553
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 7/6/19 |
| Organization Incorporation State | AL |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | E12 - Fund Raising and/or Fund Distribution |
| 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 | GERITA RYE |
| Signature Title | DIRECTOR OF SERVICES |
| Signature Date | 8/7/19 |
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