FORM 1023-EZ for THE TERRY HOUSE ON PLYMOUTH VILLAGEGREEN

Field Data
EIN 32-0473140
Case Number EO-2015265-000143
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE TERRY HOUSE ON PLYMOUTH VILLAGEGREEN
Organization’s Mailing Address 14 NORTH STREET - PO BOX 19
City PLYMOUTH
State CT
ZIP 06782
Accounting period End 12
Primary contact name KIRK M DUCHARME - DIRECTOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

KIRK DUCHARME
DIRECTOR
14 NORTH STREET
PLYMOUTH CT 06782

Officer/Director/Trustee Two

PAMELA DUCHARME
SECRETARY/TREASURER
14 NORTH STREET
PLYMOUTH CT 06782

Officer/Director/Trustee Three

REVEREND VANCE TAYLOR
ADVISOR - RELIGION
50 CEDARCROFT DRIVE
MADISON CT 06443-1832

Officer/Director/Trustee Four

PASTOR CHRIS WALKER
ADVISOR - RELIGION AND HISTORICAL
49 MERRIMAN STREET
UNIONVILLE CT 06085

Officer/Director/Trustee Five

MATT MALLEY
ADVISOR - HISTORICAL
164 PILGRIM ROAD
BRISTOL CT 06010

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/1/2015
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A80 - Historical Societies, Related Historical Activities
Organization’s purpose Charitable: No
Religious: Yes
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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