FORM 1023-EZ for GREATER PIEDMONT TRAUMA INFORMED COMMUNITY NETWORK
| Field | Data |
|---|---|
| EIN | 47-5563707 |
| Case Number | EO-2015350-000217 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | GREATER PIEDMONT TRAUMA INFORMED COMMUNITY NETWORK |
| Organization’s Mailing Address | 206 WEST EDMONDSON ST |
| City | CULPEPER |
| State | VA |
| ZIP | 22701 |
| Accounting period End | 12 |
| Primary contact name | JANE C PROBST |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $400.00 |
Officer/Director/Trustee One
JANE C PROBST
CHAIRPERSON
206 WEST EDMONDSON ST
CULPEPER VA 22701
Officer/Director/Trustee Two
LYNNE BLYTHE
VICE CHAIRPERSON
206 WEST EDMONDSON
CULPEPER VA 22701
Officer/Director/Trustee Three
JAMIE ELLEN AUSTIN
SECRETARY
206 WEST EDMONDSON ST
CULPEPER VA 22701
Officer/Director/Trustee Four
JAMIE M CLANCEY
TREASURER
206 WEST EDMONDSON ST
CULPEPER VA 22701
| Organization’s website | WWW.GPTICN.ORG |
|---|---|
| Organization’s email | JCPROBSTMSW@GMAIL.COM |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 11/6/2015 |
| Organization Incorporation State | VA |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | B11 - Single Organization Support |
| Organization’s purpose | Charitable: No 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 | Yes |
| Donation of funds | Yes |
| 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 | Yes |
| 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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