FORM 1023-EZ for OHIO PERSON-CENTERED CARE COALITION

Field Data
EIN 26-3856758
Case Number EO-2015338-000026
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name OHIO PERSON-CENTERED CARE COALITION
Organization’s Mailing Address 835 SHARON DRIVE SUITE 400
City WESTLAKE
State OH
ZIP 44145
Accounting period End 12
Primary contact name SHELLY SZAREK-SKODNY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

SHELLY SZAREK-SKODNY
PRESIDENT
835 SHARON DRIVE SUITE 400
WESTLAKE OH 44145

Officer/Director/Trustee Two

STEPHANIE DEWEES
VICE PRESIDENT
835 SHARON DRIVE SUITE 400
WESTLAKE OH 44145

Officer/Director/Trustee Three

DIONNE NICOL
TREASURER
835 SHARON DRIVE SUITE 400
WESTLAKE OH 44145

Officer/Director/Trustee Four

SAM MCCOY
SECRETARY
835 SHARON DRIVE SUITE 400
WESTLAKE OH 44145

Officer/Director/Trustee Five

HILARY STAI
MEMBER
835 SHARON DRIVE SUITE 400
WESTLAKE OH 44145

Organization’s website WWW.CENTEREDCARE.ORG
Organization’s email INFO@CENTEREDCARE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/4/2008
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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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