FORM 1023-EZ for THE AUXILIARY AT HILLSIDE REHABILITATION HOSPITAL GIFT SHOP

Field Data
EIN 82-2078765
Case Number EO-2017198-000417
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE AUXILIARY AT HILLSIDE REHABILITATION HOSPITAL GIFT SHOP
Organization’s Mailing Address 8747 SQUIRES LANE NE
City WARREN
State OH
ZIP 44484-1649
Accounting period End 6
Primary contact name DIANE MANOFSKY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DIANE COSS
PRESIDENT
207 PAULO DR NE
WARREN OH 44483-4665

Officer/Director/Trustee Two

PEGGY KROZIER
VICE PRESIDENT
7696 SUTTON PLACE NE
WARREN OH 44484-1453

Officer/Director/Trustee Three

PATTI AUGUSTINE
TREASURER
110 ROYAL TROON DR SE
WARREN OH 44484-4664

Officer/Director/Trustee Four

DIANE MANOFSKY
ASSISTANT TREASURER
1155 PAIGE AVE NE
WARREN OH 44483-3837

Officer/Director/Trustee Five

LINDA HEIM
GIFT SHOP MANAGER
4125 LONGHILL DR SE
WARREN OH 44484-2623

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/23/2017
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T70 - Fund Raising Organizations That Cross Categories
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 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
Signature Title
Signature Date

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