FORM 1023-EZ for SCIOTO COUNTY HEALTH COALITION

Field Data
EIN 47-1747822
Case Number EO-2015079-000153
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SCIOTO COUNTY HEALTH COALITION
Organization’s Mailing Address 613 CHILLICOTHE STREET SUITE 206
City PORTSMOUTH
State OH
ZIP 45662
Accounting period End 12
Primary contact name REGINA TIPTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

THURMAN EDWARD HUGHES
PRESIDENT/CHAIRMAN
613 CHILLICOTHE STREET SUITE 206
PORTSMOUTH OH 45662

Officer/Director/Trustee Two

DR AARON ADAMS
VICE PRESIDENT
613 CHILLICOTHE STREET SUITE 206
PORTSMOUTH OH 45662

Officer/Director/Trustee Three

CHRIS SMITH
SECRETARY/TREASURER
613 CHILLICOTHE STREET SUITE 206
PORTSMOUTH OH 45662

Officer/Director/Trustee Four

JASON KESTER
BOARD MEMBER
613 CHILLICOTHE STREET SUITE 206
PORTSMOUTH OH 45662

Officer/Director/Trustee Five

SHARON CARVER
BOARD MEMBER
613 CHILLICOTHE STREET SUITE 206
PORTSMOUTH OH 45662

Organization’s website WWW.SCIOTOHEALTH.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/5/2014
Organization Incorporation State OH
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 Yes
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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