FORM 1023-EZ for METANOIA OF VERMONT INC

Field Data
EIN 84-2175824
Case Number EO-2019317-000065
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name METANOIA OF VERMONT INC
Organization’s Mailing Address 140 MAPLE HILL RD
City THETFORD CENTER
State VT
ZIP 5075-4407
Accounting period End 12
Primary contact name LISA KUTOLOWSKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LISA KUTOLOWSKI
CO-DIRECTOR
140 MAPLE HILL RD
THETFORD CENTER VT 5057-4407

Officer/Director/Trustee Two

MARK KUTOLOWSKI
CO-DIRECTOR
140 MAPLE HILL RD
THETFORD CENTER VT 5075-4407

Officer/Director/Trustee Three

SIMON DENNIS
TREASURER
140 LATHAM WORKS LANE
WHITE RIVER JUNCTION VT 5001-7086

Officer/Director/Trustee Four

DUNCAN HILTON
CHAIRPERSON
191 CLARK AVE UNIT 3
BRATTLEBORO VT 5031-3403

Officer/Director/Trustee Five

ROBIN YUNKER-BOYCE
SECRETARY
113 ACADEMY ROAD
THETFORD CENTER VT 5075-9044

Organization’s website WWW.METANOIAVT.COM
Organization’s email INFO@METANOIAVT.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/18/19
Organization Incorporation State VT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
Religious: Yes
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 Yes
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 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 LISA KUTOLOWSKI
Signature Title CO-DIRECTOR
Signature Date 11/11/19

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