FORM 1023-EZ for FAYETTE COUNTY HUMAN SERVICE COUNCIL

Field Data
EIN 25-1291946
Case Number EO-2015216-000425
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FAYETTE COUNTY HUMAN SERVICE COUNCIL
Organization’s Mailing Address 137 NORTH BEESON AVENUE
City UNIONTOWN
State PA
ZIP 15401-2936
Accounting period End 12
Primary contact name STACEY PAPABOARD VICE PRESIDENT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

FRANCES BROWNFIELD
PRESIDENT, BOARD OF DIRECTORS
137 NORTH BEESON AVENUE
UNIONTOWN PA 15401

Officer/Director/Trustee Two

RITA MASI
TREASURER
108 NORTH BEESON AVENUE
UNIONTOWN PA 15401

Officer/Director/Trustee Three

STACEY PAPA
VICE PRESIDENT
2 WEST MAIN STREET SUITE 715
UNIONTOWN PA 15401

Officer/Director/Trustee Four

ERICA USHER
SECRETARY
100 OLD NEW SALEM ROAD NO 106
UNIONTOWN PA 15401

Officer/Director/Trustee Five

DAVE RIDER
DIRECTOR
215 JACOB MURPHY LANE
UNIONTOWN PA 15401

Organization’s website WWW.FAYETTEHUMANSERVICECOUNCIL.ORG
Organization’s email FAYETTEHSC@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/27/1978
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P03 - Professional Societies, Associations
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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