FORM 1023-EZ for NORTH MIDDLESEX COMMUNITY CARES

Field Data
EIN 46-5502983
Case Number EO-2016055-000087
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NORTH MIDDLESEX COMMUNITY CARES
Organization’s Mailing Address 3 SIRIUS LANE
City PEPPERELL
State MA
ZIP 01463
Accounting period End 12
Primary contact name MARY MORGAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

THERESE LAROSE
PRESIDENT
103 CHESTNUT STREET
PEPPERELL MA 01463

Officer/Director/Trustee Two

MARY MORGAN
SECRETARY
3 SIRIUS LANE
PEPPERELL MA 01463

Officer/Director/Trustee Three

GAIL DERBOGHOSIAN
TREASURER
64 MEADOW STREET
TOWNSEND MA 01474

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/30/2014
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F21 - Alcohol, Drug Abuse, Prevention Only
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 Yes
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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