FORM 1023-EZ for COUNTRY POND LAKE ASSOCIATION

Field Data
EIN 82-3176466
Case Number EO-2017319-000128
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COUNTRY POND LAKE ASSOCIATION
Organization’s Mailing Address 74 WILDERS GROVE ROAD
City NEWTON
State NH
ZIP 03858
Accounting period End 12
Primary contact name GREGORY SENKO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TULLY ZIPKIN
PRESIDENT
58 WILDERS GROVE ROAD
NEWTON NH 03858

Officer/Director/Trustee Two

GREGORY SENKO
VICE-PRESIDENT
18 SUNSHINE DRIVE
KINGSTON NH 03848

Officer/Director/Trustee Three

JEANNE CASHIN
SECRETARY
74 WILDERS GROVE ROAD
NEWTON NH 03858

Officer/Director/Trustee Four

JENNIFER WEST
TREASURER
2 RIDGE ROAD
NEWTON NH 03858

Officer/Director/Trustee Five

LINDA FOSS
BOARD MEMBER
18 SUNSHINE DRIVE
KINGSTON NH 03848

Organization’s website COUTRYPONDLAKEASSOCIATION.ORG
Organization’s email COUNTRYPONDLA@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/11/2017
Organization Incorporation State NH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code C32 - Water Resource, Wetlands Conservation and Management
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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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