FORM 1023-EZ for CHARLESTOWN MEDICAL BUILDING ASSOCIATION INC

Field Data
EIN 36-4837360
Case Number EO-2017261-000101
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHARLESTOWN MEDICAL BUILDING ASSOCIATION INC
Organization’s Mailing Address PO BOX 836
City CHARLESTOWN
State NH
ZIP 03603
Accounting period End 12
Primary contact name JUDITH A BARALY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEFFREY LESSELS
PRESIDENT/TREASURER
122 SOUTHWEST ST
CHARLESTOWN NH 03603

Officer/Director/Trustee Two

NANCY HOUGHTON
SECRETARY
1057 OLD CHESHIRE TPKE
CHARLESTOWN NH 03603

Officer/Director/Trustee Three

MARK FRIZZELL
DIRECTOR
2821 SHERWOOD DRIVE
TROPHY CLUB TX 76267

Officer/Director/Trustee Four

JUDITH BARALY
BOARD MEMBER
10 TAYLOR HILL ROAD
CHARLESTOWN NH 03603

Organization’s website NA
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/23/1966
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
Signature Title
Signature Date

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