FORM 1023-EZ for MARK ROBERT BOUCHER MEMORIAL FUND INC

Field Data
EIN 81-2893657
Case Number EO-2016196-000505
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MARK ROBERT BOUCHER MEMORIAL FUND INC
Organization’s Mailing Address P O BOX 275
City EASTON
State MA
ZIP 02356
Accounting period End 12
Primary contact name KIM BAKEBERG
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAKE BOUCHER
PRESIDENT
76 MILL STREET
NO EASTON MA 02356

Officer/Director/Trustee Two

DANIEL SNOW
TREASURER
9 MISTY LANE
YARMOUTH MA 02664

Officer/Director/Trustee Three

PATRICIA BOUCHER
SECRETARY
76 MILL STREET
NO EASTON MA 02664

Officer/Director/Trustee Four

KENDYLL BOUCHER
VICE PRESIDENT
76 MILL STREET
NO EASTON MA 02664

Officer/Director/Trustee Five

JOHN MOREY
DIRECTOR
15 SMITH ROAD
MILTON MA 02186

Organization’s website WWW.BOOSHFUND.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/17/2016
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B82 - Scholarships, Student Financial Aid Services, Awards
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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