FORM 1023-EZ for BERGEN COUNTY HEALTH IMPROVEMENT PARTNERSHIP

Field Data
EIN 82-3995528
Case Number EO-2018057-000325
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BERGEN COUNTY HEALTH IMPROVEMENT PARTNERSHIP
Organization’s Mailing Address 73 SOUTH VAN BRUNT
City ENGLEWOOD
State NJ
ZIP 7631
Accounting period End 12
Primary contact name JAMES FEDORKO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES FEDORKO
PRESIDENT
73 SOUTH VAN BRUNT STREET
ENGLEWOOD NJ 7631

Officer/Director/Trustee Two

JUDITH MIGLIACCIO
VICE PRESIDENT
1 JOCKISH SQUARE
PARAMUS NJ 7652

Officer/Director/Trustee Three

KENNETH KATTER
CFO
818 TEANECK ROAD
TEANECK NJ 7666

Officer/Director/Trustee Four

MARLA KLEIN
COORIDINATOR
ONE BERGEN COUNTY PLAZA 4TH FLOOR
HACKENSACK NJ 7601

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/5/17
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
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 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 JAMES FEDORKO
Signature Title PRESIDENT
Signature Date 2/22/18

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