FORM 1023-EZ for BALLINGER MEMORIAL HOSPITAL DISTRICT HEALTH FOUNDATION

Field Data
EIN 27-5559128
Case Number EO-2014276-000253
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BALLINGER MEMORIAL HOSPITAL DISTRICT HEALTH FOUNDATION
Organization’s Mailing Address PO BOX 617
City BALLINGER
State TX
ZIP 76821
Accounting period End 9
Primary contact name GRADY HOOPER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

GRADY HOOPER
EXECUTIVE DIRECTOR
1702 N BROADWAY ST
BALLINGER TX 76821

Officer/Director/Trustee Two

MIKE DANKWORTH
SECRETARY/TREASURER
1702 N BROADWAY ST
BALLINGER TX 76821

Officer/Director/Trustee Three

RODNEY FLANAGAN
CHAIRMAN
1702 N BROADWAY ST
BALLINGER TX 76821

Officer/Director/Trustee Four

JAMES STUDER
VICE CHAIRMAN
1702 N BROADWAY ST
BALLINGER TX 76821

Officer/Director/Trustee Five

LAURA MALLORY
ASST SECRETARY
1702 N BROADWAY ST
BALLINGER TX 76821

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/11/2011
Organization Incorporation State TX
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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
Signature Title
Signature Date

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