FORM 1023-EZ for CLEVELAND AREA HOSPITAL AUXILIARY

Field Data
EIN 82-4118540
Case Number EO-2018032-000267
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CLEVELAND AREA HOSPITAL AUXILIARY
Organization’s Mailing Address 101 SOUTH GILBERT AVE
City CLEVELAND
State OK
ZIP 74020
Accounting period End 12
Primary contact name BRITTANY GRAY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BRITTANY GRAY
PRESIDENT
101 SOUTH GILBERT STREET
CLEVELAND OK 74020

Officer/Director/Trustee Two

ALENE SPARKS
VICE PRESIDENT
303 NORTH B AVE
CLEVELAND OK 74020

Officer/Director/Trustee Three

ILAINE WILLIAMS
SECRETARY
1122 WEST OSAGE STREET
CLEVELAND OK 74020

Officer/Director/Trustee Four

DONALD WILLIAMS
TREASURER
1122 WEST OSAGE STREET
CLEVELAND OK 74020

Officer/Director/Trustee Five

JEAN ALLISON
VOLUNTEER COORDINATOR
402 NORTH B AVE
CLEVELAND OK 74020

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/15
Organization Incorporation State OK
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E11 - Single Organization Support
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 BRITTANY GRAY
Signature Title PRESIDENT
Signature Date 1/30/18

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