FORM 1023-EZ for WOMENS CANCER COALITION OF MONTEZUMA AND DOLORES COUNTIES

Field Data
EIN 27-4284373
Case Number EO-2015231-000286
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name WOMENS CANCER COALITION OF MONTEZUMA AND DOLORES COUNTIES
Organization’s Mailing Address PO BOX 240
City DOLORES
State CO
ZIP 81323
Accounting period End 12
Primary contact name ANNA WESLING
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CONNIE FISHER
PRESIDENT
PO BOX 576
DOVE CREEK CO 81324

Officer/Director/Trustee Two

TIFFANI WATERS
VICE PRESIDENT
34 E MAIN ST
CORTEZ CO 81321

Officer/Director/Trustee Three

GINGER KINGMAN
TREASURER
28470 RD 38
DOLORES CO 81323

Officer/Director/Trustee Four

SUE THOMPKINS
SECRETARY
PO BOX 240
DOLORES CO 81323

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/1/2010
Organization Incorporation State CO
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 -
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 Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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