FORM 1023-EZ for THE GRATEFUL CAFE SOBER CLUB

Field Data
EIN 82-1846574
Case Number EO-2018134-000395
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE GRATEFUL CAFE SOBER CLUB
Organization’s Mailing Address 270 MAIN ST
City TILTON
State NH
ZIP 3276
Accounting period End 12
Primary contact name CAROLEE LONGLEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MICHAEL FITZPATRICK
FOUNDING DIRECTOR
270 MAIN ST
TILTON NH 3276

Officer/Director/Trustee Two

MICHAEL ADAMS
BOARD PRESIDENT
6 CUMBERLAND RD UNIT 23
GILFORD NH 3249

Officer/Director/Trustee Three

STEPHEN FOSTER
BOARD TREASURER
380 WEST MAIN ST
TILTON NH 3276

Officer/Director/Trustee Four

CATHY WHEELER
BOARD SECRETARY
24 WEST BOW ST APT 2
FRANKLIN NH 3235

Officer/Director/Trustee Five

KATIE POISON
BOARD VICE PRESIDENT
PO BOX 524
TILTON NH 3276

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/17
Organization Incorporation State NH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 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 MICHAEL FITZPATRICK
Signature Title FOUNDING DIRECTOR
Signature Date 5/12/18

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