FORM 1023-EZ for NEW MEXICO ELDER MEDIATION NETWORK

Field Data
EIN 47-3131492
Case Number EO-2015072-000648
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NEW MEXICO ELDER MEDIATION NETWORK
Organization’s Mailing Address 10 WIND RD NW
City ALBUQUERQUE
State NM
ZIP 87120
Accounting period End 12
Primary contact name WALLACE FORD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RITA CRITCHFIELD
DIRECTOR
157 RIVERSIDE DR SW
ALBUQUERQUE NM 87105

Officer/Director/Trustee Two

BRENDA HORVATH
SECRETARY
4140 DIETZ FARM CIR
LOS RANCHOS NM 87105

Officer/Director/Trustee Three

SUE THORSON
VICE-PRESIDENT
1614 BETTS CT NE
ALBUQUERQUE NM 87112

Officer/Director/Trustee Four

MARCIA BERKOWITZ
PRESIDENT
761 VALLEY MEADOWS DR NE
RIO RANCHO NM 87144

Officer/Director/Trustee Five

MARLYN GIBBS
TREASURER
918 PRAIRIE ZENNIA
BERNALILLO NM 87004

Organization’s website WWW.NMELDER.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/29/2015
Organization Incorporation State NM
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I51 - Dispute Resolution, Mediation Services
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 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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