FORM 1023-EZ for KETA

Field Data
EIN 81-2676351
Case Number EO-2016202-000441
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name KETA
Organization’s Mailing Address 3 WAYCOTT WAY
City SACO
State ME
ZIP 04072
Accounting period End 12
Primary contact name AMY FOURNIER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CYNTHIA KILBRIDE
PRESIDENT AND DIRECTOR
1 HERITAGE DRIVE
STANDISH ME 04084

Officer/Director/Trustee Two

AMY FOURNIER
TREASURER AND DIRECTOR
3 WAYCOTT WAY
SACO ME 04072

Officer/Director/Trustee Three

EMILY MORRIS
DIRECTOR
39 BELMONT STREET
BRUNSWICK ME 04011

Officer/Director/Trustee Four

LISA BRIDGE-KOENIGSBERG
DIRECTOR
29 STONE DRIVE
CAPE ELIZABETH ME 04107

Officer/Director/Trustee Five

GARY LANDERS
DIRECTOR
57 MILL STREET EXTENSION
LANCASTER MA 01523

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/18/2016
Organization Incorporation State ME
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E60 - Health Support Services
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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