FORM 1023-EZ for FAIRFIELD COUNTY TRAUMA RECOVERY NETWORK INC
| Field | Data |
|---|---|
| EIN | 83-2759593 |
| Case Number | EO-2019037-000332 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | FAIRFIELD COUNTY TRAUMA RECOVERY NETWORK INC |
| Organization’s Mailing Address | 540 TUNXIS HILL RD |
| City | FAIRFIELD |
| State | CT |
| ZIP | 6825-4412 |
| Accounting period End | 12 |
| Primary contact name | SUSAN MARCUS |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
SUSAN MARCUS
DIRECTOR; PRESIDENT
540 TUNXIS HILL RD
FAIRFIELD CT 6825-4412
Officer/Director/Trustee Two
LINDA ROST
DIRECTOR; VICE PRESIDENT
540 TUNXIS HILL RD
FAIRFIELD CT 6825-4412
Officer/Director/Trustee Three
LIBBY SCHREIBER
DIRECTOR; SECRETARY
540 TUNXIS HILL RD
FAIRFIELD CT 6825-4412
Officer/Director/Trustee Four
DAWN ROY
DIRECTOR; TREASURER
540 TUNXIS HILL RD
FAIRFIELD CT 6825-4412
Officer/Director/Trustee Five
KAREN ALTER-REID
DIRECTOR; CLINICAL DIRECTOR
540 TUNXIS HILL RD
FAIRFIELD CT 6825-4412
| Organization’s website | FCTRN.COM |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 12/4/18 |
| Organization Incorporation State | CT |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | F99 - Mental Health, Crisis Intervention N.E.C. |
| Organization’s purpose | Charitable: No Religious: No Educational: Yes 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 | 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 | Yes |
| One Third Support Public | Yes |
| One Third Support Gifts | No |
| Benefit of College | No |
| Private Foundation 508(e) | No |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | SUSAN MARCUS |
| Signature Title | DIRECTOR; PRESIDENT |
| Signature Date | 1/29/19 |
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