FORM 1023-EZ for MEDINA COUNTY SENIOR SERVICES NETWORK INC

Field Data
EIN 34-1780661
Case Number EO-2017289-000209
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MEDINA COUNTY SENIOR SERVICES NETWORK INC
Organization’s Mailing Address 246 NORTHLAND DRIVE
City MEDINA
State OH
ZIP 44256
Accounting period End 12
Primary contact name LAURIE B PRICE CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

WENDY L MORGAN
CHAIRPERSON
319 SOUTH COURT STREET
MEDINA OH 44256

Officer/Director/Trustee Two

SUSAN SCHIPPEL
PRESIDENT
49 LEISURE LANE
MEDINA OH 44256

Officer/Director/Trustee Three

KENT VONDERVELLEN
CO-TREASURER
4081 EMBASSY PARKWAY
AKRON OH 44333

Officer/Director/Trustee Four

DAVE PETERS
CO-TREASURER
6200 ROCKSIDE ROAD
INDEPDENCE OH 44131

Officer/Director/Trustee Five

SUZANNE NEDELKA
CO-SECRETARY
100 HIGHPOINT DRIVE
MEDINA OH 44256

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/10/2017
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T01 - Alliance/Advocacy Organizations
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 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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