FORM 1023-EZ for COUNTY FARM HOSPICE HOUSE INC

Field Data
EIN 84-4065161
Case Number EO-2020002-000166
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name COUNTY FARM HOSPICE HOUSE INC
Organization’s Mailing Address 3204 E STATE RD 61
City VINCENNES
State IN
ZIP 47591
Accounting period End 12
Primary contact name ANGELA BARMES
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANGELA BARMES
PRESIDENT
3204 E STATE RD 61
VINCENNES IN 47591

Officer/Director/Trustee Two

ANDREW BARMES
SECRETARY
3204 E STATE RD 61
VINCENNES IN 47591

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/6/2019
Organization Incorporation State IN
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P74 - Hospice
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 ANGELA BARMES
Signature Title PRESIDENT
Signature Date 12/30/2019

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