FORM 1023-EZ for JEFFERSON VILLAGE COMMUNITY CENTERCORPORATION

Field Data
EIN 85-3861213
Case Number EO-2021179-000219
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name JEFFERSON VILLAGE COMMUNITY CENTERCORPORATION
Organization’s Mailing Address 82 NORTH MOUNTAIN ROAD
City JEFFERSON
State ME
ZIP 04348
Accounting period End 12
Primary contact name TERRY BEAL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LAUREN COMSTOCK
PRESIDENT & DIRECTOR
82 NORTH MOUNTAIN ROAD
JEFFERSON ME 04348

Officer/Director/Trustee Two

TERRY BEAL
TREASURER & DIRECTOR
84 OLD COUNTY ROAD
JEFFERSON ME 04348

Officer/Director/Trustee Three

LINDA PIERPONT
SECRETARY & DIRECTOR
PO BOX 162
JEFFERSON ME 04348

Officer/Director/Trustee Four

JOAN JACKSON
DIRECTOR &VICE PRESIDENT
PO BOX 227
JEFFERSON ME 04348

Officer/Director/Trustee Five

JENNIFER BRENNAN
DIRECTOR
462 EAST POND ROAD
JEFFERSON ME 04348

Organization’s website REVITALIZEJEFFERSON.COM
Organization’s email REVITALIZEJEFFERSON@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/27/2020
Organization Incorporation State ME
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N31 - Community Recreational Centers
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 LAUREN COMSTOCK
Signature Title PRESIDENT & DIRECTOR
Signature Date 6/24/2021

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