FORM 1023-EZ for EASTSIDE HEALTH FOUNDATION

Field Data
EIN 82-3366957
Case Number EO-2017331-000168
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name EASTSIDE HEALTH FOUNDATION
Organization’s Mailing Address 2 BRADLEY RD FL 2
City MILFORD
State ME
ZIP 04461
Accounting period End 10
Primary contact name DAVID AKO-ANNAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAVID AKO-ANNAN
CEO
2 BRADLEY RD
MILFORD ME 04461

Officer/Director/Trustee Two

FRANK KWAWUKUME
EXECUTIVE VICE PRESIDENT
28 RHODE ISLAND ST
OLD TOWN ME 04468

Officer/Director/Trustee Three

MAITE HECHAVARRIA
VICE PRESIDENT
132 LINCOLN ST
BANGOR ME 04401

Officer/Director/Trustee Four

MELINDA STODDARD
PROGRAM DIRECTOR
10 SAVAGE ST
FAIRFIELD ME 04937

Officer/Director/Trustee Five

RAYMOND ODOI
VICE PRESIDENT
144 MAIN ST
OLD TOWN ME 04468

Organization’s website HTTPS://WWW.EASTSIDEHF.ORG
Organization’s email EASTSIDEHEALTHFOUNDATION@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/2017
Organization Incorporation State ME
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T50 - Philanthropy, Charity, Voluntarism Promotion, General
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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