FORM 1023-EZ for HEALTHY COMMUNITIES COALITION

Field Data
EIN 84-5015496
Case Number EO-2020076-000395
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HEALTHY COMMUNITIES COALITION
Organization’s Mailing Address 881 MAIN ST
City CARRINGTON
State ND
ZIP 58421-1257
Accounting period End 12
Primary contact name JENNIFER WHITMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

APRIL FOTH
PRESIDENT
561 MAIN ST
CARRINGTON ND 58421-1257

Officer/Director/Trustee Two

JENNIFER WHITMAN
VICE PRESIDENT
19 6TH ST SE
CARRINGTON ND 58421-1257

Officer/Director/Trustee Three

ANGELA BOESHANS
SECRETARY/TREASURER
1021 3RD ST N
CARRINGTON ND 58421-1257

Officer/Director/Trustee Four

LISA HILBERT
DIRECTOR AT LARGE
1309 3RD ST S
CARRINGTON ND 58421-1257

Organization’s website N/A
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/9/2020
Organization Incorporation State ND
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S21 - Community Coalitions
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 No
Correctness Declaration Yes
Signature Name JENNIFER WHITMAN
Signature Title VICE PRESIDENT
Signature Date 3/13/2020

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