FORM 1023-EZ for THE JOHN BROOK ARCHIVE

Field Data
EIN 86-2440642
Case Number EO-2021104-000790
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE JOHN BROOK ARCHIVE
Organization’s Mailing Address 6 HOLT STREET
City CONCORD
State NH
ZIP 03301
Accounting period End 6
Primary contact name THOMAS ADAMS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

THOMAS ADAMS
PRESIDENT
6 HOLT STREET
CONCORD NH 03301-2925

Officer/Director/Trustee Two

HOPE ZANES-BUTTERWORTH
TREASURER
90 STICKNEY ROAD
CONCORD NH 03301-1802

Officer/Director/Trustee Three

PAT NELSON
SECRETARY
287 RUSSELL STATION ROAD
FRANCISTOWN NH 03043-3707

Officer/Director/Trustee Four

ANDREW KYRIAKOUTSAKIS
BOARD MEMBER
21 SOUTH STREET
WELLS ME 04090-4530

Organization’s website JOHNBROOKARCHIVE.COM
Organization’s email JOHNBROOKPHOTOGRAPHY@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/17/2021
Organization Incorporation State NH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 THOMAS ADAMS
Signature Title PRESIDENT
Signature Date 4/12/2021

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