FORM 1023-EZ for MAD RIVER MEDIA INC

Field Data
EIN 84-4569071
Case Number EO-2020045-000242
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MAD RIVER MEDIA INC
Organization’s Mailing Address 11 TEN ST
City PINE MEADOW
State CT
ZIP 06061
Accounting period End 12
Primary contact name DAVID WHITNEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID WHITNEY
PRESIDENT
11 TEN ST
PINE MEADOW CT 06061

Officer/Director/Trustee Two

SHANNON WHITNEY
SECRETARY
11 TEN ST
PINE MEADOW CT 06061

Officer/Director/Trustee Three

JAMES MACGILIVARY
DIRECTOR
117 SPENCER ST
WINSTED CT 06098

Officer/Director/Trustee Four

PAT DIMAURO
DIRECTOR
40 TOWN LINE RD
NEW HARTFORD CT 06057

Officer/Director/Trustee Five

MICHAEL KURTZ
DIRECTOR
296 NILES RD
NEW HARTFORD CT 06057

Organization’s website
Organization’s email DAVE@WHITNEYPRO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/4/2020
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A30 - Media, Communications Organizations
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DAVID WHITNEY
Signature Title PRESIDENT
Signature Date 2/12/2020

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