FORM 1023-EZ for BLACK BEAR ACRES INC

Field Data
EIN 83-2163014
Case Number EO-2019031-000865
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BLACK BEAR ACRES INC
Organization’s Mailing Address PO BOX 104
City ERROL
State NH
ZIP 3579
Accounting period End 12
Primary contact name MARY PAULHAMUS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARY PAULHAMUS
PRESIDENT
PO BOX 104
ERROL NH 3579-104

Officer/Director/Trustee Two

MARGARET DONOHUE
TREASURER
386 ROUTE 103 EAST
WARNER NH 3278

Officer/Director/Trustee Three

RICHARD PAULHAMUS
VICE PRESIDENT/ CHAIRPERSON OF GOVE
PO BOX 104
ERROL NH 3579

Officer/Director/Trustee Four

MEGAN HOOD
SECRETARY
435 CARLETON HILL RD
COLUMBIA NH 3576

Officer/Director/Trustee Five

DEREK EASTMAN
DIRECTOR/ THERAPEUTIC ADVISER
38 ALPINE ST
GORHAM NH 3581

Organization’s website
Organization’s email RUNFORLIFE717@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/9/18
Organization Incorporation State NH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N69 - Equestrian, Riding
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 MARY PAULHAMUS
Signature Title PRESIDENT
Signature Date 1/7/19

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