FORM 1023-EZ for MARY KEANE FOUNDATION FOR GERIATICSEXCELLENCE INC

Field Data
EIN 81-3233188
Case Number EO-2016208-000030
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MARY KEANE FOUNDATION FOR GERIATICSEXCELLENCE INC
Organization’s Mailing Address 16331 BLUE TEAL TRAIL
City HEMLOCK
State MI
ZIP 48626
Accounting period End 12
Primary contact name DANIEL KEANE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DANIEL KEANE
PRESIDENT/TREASURER
16331 Blue Teal Trail
HEMLOCK MI 48626

Officer/Director/Trustee Two

HEATHER GRAHAM
SECRETARY
23 CIRCLE VISTA DR
ANTHONY NM 88021

Officer/Director/Trustee Three

LAURA FAUBERT
VICE-PRESIDENT
379 SANDRIDGE
HEMLOCK MI 48626

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/6/2016
Organization Incorporation State MI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G94 - Geriatrics
Organization’s purpose Charitable: Yes
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 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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