FORM 1023-EZ for CT DDS FAMILIES FIRST INC

Field Data
EIN 81-0803152
Case Number EO-2015348-000406
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CT DDS FAMILIES FIRST INC
Organization’s Mailing Address 189 NEWINGTON RD APT 112
City WEST HARTFORD
State CT
ZIP 06110-2328
Accounting period End 11
Primary contact name RICHARD ROTHSTEIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

FRANK KING
PRESIDENT AND DIRECTOR
252 CHAPPELL RD
LEBANON CT 06249-1219

Officer/Director/Trustee Two

RICHARD ROTHSTEIN
TREASURER AND DIRECTOR
189 NEWINGTON ROAD APT 112
WEST HARTFORD CT 06110-2328

Officer/Director/Trustee Three

MARINA DERMAN
SECRETARY AND DIRECTOR
8 TIMBER LANE
WESTPORT CT 06880-2621

Officer/Director/Trustee Four

DAWN DEMATTEO
DIRECTOR
80 SYLVAN HILLS ROAD
EAST HAVEN CT 06513-1949

Officer/Director/Trustee Five

SUSAN BASTIEN
DIRECTOR
262 WEATHERSIDE LANE
CHESHIRE CT 06410-4330

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/7/2015
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G01 - Alliance/Advocacy Organizations
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
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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