FORM 1023-EZ for CROMWELL FARMERS MARKET CORP

Field Data
EIN 47-3766357
Case Number EO-2015127-000362
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CROMWELL FARMERS MARKET CORP
Organization’s Mailing Address 12 PONDVIEW DR
City CROMWELL
State CT
ZIP 06416-2023
Accounting period End 12
Primary contact name HEATHER POLKE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

HEATHER POLKE
PRESIDENT/DIRECTOR
12 PONDVIEW DR
CROMWELL CT 06416-2023

Officer/Director/Trustee Two

DAWN BRENNER
TREASURER/DIRECTOR
17 MADISON LN
WEST SIMSBURY CT 06092-2615

Officer/Director/Trustee Three

JEFF POLKE
SECRETARY/DIRECTOR
66 KILLINGWORTH RD
HIGGANUM CT 06441-4241

Organization’s website WWW.CROMWELLFARMERSMARKET.ORG/
Organization’s email CROMWELLFARMERSMARKET@COMCAST.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/16/2015
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
Organization’s purpose Charitable: Yes
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 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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