FORM 1023-EZ for FRIENDS OF MIDDLEBURY GOD PARK

Field Data
EIN 46-5215175
Case Number EO-2015327-000290
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FRIENDS OF MIDDLEBURY GOD PARK
Organization’s Mailing Address 101 YALE AVE
City M IDDLEBURY
State CT
ZIP 06762
Accounting period End 12
Primary contact name BEVERLY DASSONVILLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

BEVERLY DASSONVILLE
PRESIDENT
101 YALE AVE
MIDDLEBURY CT 06762

Officer/Director/Trustee Three

POLLY WILSON
BOOKKEEPER
108 WHITE AVE
MIDDLEBURY CT 06762

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/5/2014
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D11 - Single Organization Support
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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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