FORM 1023-EZ for PHYSICAL THERAPY BOARD OF CRANIOFIACIAL THERAPEUTICS

Field Data
EIN 47-4005813
Case Number EO-2016005-000115
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PHYSICAL THERAPY BOARD OF CRANIOFIACIAL THERAPEUTICS
Organization’s Mailing Address 83 GLEN ROAD
City WOODCLIFF LAKE
State NJ
ZIP 07677
Accounting period End 12
Primary contact name KEVIN LEEDS CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JEFFREY MANNHEIRER
PRESIDENT
456 FRANKLIN COURNER RD
LAWERENCEVILLEE NJ 08648

Officer/Director/Trustee Two

JOHN DUNN
TREASURER
83 GLEN RD
WOODCLIFF LAKE NJ 07677

Officer/Director/Trustee Three

JULES HESSE
VICE PRESIDENT
AMERSTERDAM
NETHERLANDS

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/25/2007
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B03 - Professional Societies, Associations
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 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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