FORM 1023-EZ for CORNERSTONE NONPROFIT HEALTHCARE

Field Data
EIN 81-4710090
Case Number EO-2021127-000213
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CORNERSTONE NONPROFIT HEALTHCARE
Organization’s Mailing Address 13112 HAMILTON ST
City OMAHA
State NE
ZIP 68154
Accounting period End 6
Primary contact name CAROL J SZCZEPANIAK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CAROL J SZCZEPANIAK
SECRETARY
13112 HAMILTON ST
OMAHA NE 68154

Officer/Director/Trustee Two

SHAUN GRAMMER
PRESIDENT
21426 MCCLELLAN CIRCLE
GRETNA NE 68028-6910

Officer/Director/Trustee Three

ALANA SCHRIVER
VICE PRESIDENT
3610 DODGE ST
OMAHA NE 68131

Organization’s website WWW.CORNERSTONENPH.ORG
Organization’s email CPORNERSTONENONPROFIT@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/14/2016
Organization Incorporation State NE
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G90 - Medical Disciplines
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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 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 CAROL J SZCZEPANIAK
Signature Title SECRETARY
Signature Date 5/5/2021

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