FORM 1023-EZ for GLIOBLASTOMA SUPPORT NETWORK
| Field | Data |
|---|---|
| EIN | 85-0702275 |
| Case Number | EO-2021111-000077 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | GLIOBLASTOMA SUPPORT NETWORK |
| Organization’s Mailing Address | 5809 KANE HOLLY STREET |
| City | LAS VEGAS |
| State | NV |
| ZIP | 89130 |
| Accounting period End | 3 |
| Primary contact name | JAIME DYKE |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
JAIME DYKE
PRESIDENT
69 FRONT STREET
ADDISON NY 14801
Officer/Director/Trustee Two
DEDEE CULLY
VICE PRESIDENT
926 N RIDGEMONT ROAD
REPUBLIC MO 65738-2709
Officer/Director/Trustee Three
KAREN SCHNABLE
SECRETARY
42 CARPENTER STREET
REHOBOTH MA 02769
Officer/Director/Trustee Four
STACY NELSON
TREASURER
PO BOX 1776
OVERTON NV 89040
Officer/Director/Trustee Five
KIM PETERSON
DIRECTOR
321 MAPLE COURT
GRANGEVILLE ID 82530
| Organization’s website | HTTPS://WWW.GLIOBLASTOMASUPPORT.ORG |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 4/13/2020 |
| Organization Incorporation State | NV |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | H30 - Cancer Research |
| Organization’s purpose | Charitable: Yes Religious: No Educational: No 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 | Yes |
| Correctness Declaration | Yes |
| Signature Name | JAIME DYKE |
| Signature Title | PRESIDENT |
| Signature Date | 4/17/2021 |
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