FORM 1023-EZ for BARBOURVILLE ARH HOSPITAL AUXILIARYINC

Field Data
EIN 83-0575886
Case Number EO-2018172-000220
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BARBOURVILLE ARH HOSPITAL AUXILIARYINC
Organization’s Mailing Address 80 HOSPITAL DRIVE
City BARBOURVILLE
State KY
ZIP 40906
Accounting period End 12
Primary contact name BARBARA WORLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STELLA SMITH
BOARD MEMBER
PO BOX 117
BARBOURVILLE KY 40906

Officer/Director/Trustee Two

SHEILA HALTER
BOARD MEMBER
92 FOREST DRIVE
BARBOURVILLE KY 40906

Officer/Director/Trustee Three

BARBARA WORLEY
BOARD MEMBER
403 W HENSON LANE
BARBOURVILLE KY 40906

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/21/18
Organization Incorporation State KY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E11 - Single Organization Support
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name BARBARA WORLEY
Signature Title BOARD MEMBER
Signature Date 6/19/18

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