FORM 1023-EZ for GERIATRIC BEHAVIOR LABORATORY - GERBL

Field Data
EIN 47-2274118
Case Number EO-2016105-000262
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GERIATRIC BEHAVIOR LABORATORY - GERBL
Organization’s Mailing Address 1231 NORTH MAIN STREET
City HENDERSONVILLE
State NC
ZIP 28792
Accounting period End 12
Primary contact name JOHN V KELLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JOHN KELLER
DR
1231 NORTH MAIN STREET
HENDERSONVILLE NC 28792

Organization’s website WWW.GERBL.ORG
Organization’s email JVKELLER@GERBL.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/14/2014
Organization Incorporation State NC
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code V23 - Behavioral Science
Organization’s purpose Charitable: No
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
Signature Title
Signature Date

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