FORM 1023-EZ for CHD COALITION - NORTH CENTRAL PA CHAPTER

Field Data
EIN 35-2542153
Case Number EO-2015295-000442
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CHD COALITION - NORTH CENTRAL PA CHAPTER
Organization’s Mailing Address 3286 MEFFERTS RUN RD
City WILCOX
State PA
ZIP 15870
Accounting period End 12
Primary contact name JANA WALTERS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JANA WALTERS
PRESIDENT
3286 MEFFERTS RUN RD
WILCOX PA 15870

Officer/Director/Trustee Two

TODD WALTERS
VICE PRESIDENT
3286 MEFFERTS RUN RD
WILCOX PA 15870

Officer/Director/Trustee Three

JILL MCMAHON
TREASURER
171 JOY GARDENS
WILCOX PA 15870

Officer/Director/Trustee Four

CARA GORE
SECRETARY
151 CATALINA ROAD
ST. MARYS PA 15857

Officer/Director/Trustee Five

RANDI MEANS
BOARD MEMBER
311 BEAMER DRIVE
DUNCANSVILLE PA 16635

Organization’s website
Organization’s email JANA.WALTERS@CHDCOALITION.ORG
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/2015
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - Fund Raising and/or Fund Distribution
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 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 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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