FORM 1023-EZ for ST DAMIEN COLLABORATIVE

Field Data
EIN 81-5258226
Case Number EO-2019339-000298
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ST DAMIEN COLLABORATIVE
Organization’s Mailing Address 4512 BISCAYNE DR
City VIRGINIA BEACH
State VA
ZIP 23455
Accounting period End 12
Primary contact name JAMES MALCOLM SCHMIDT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JAMES SCHMIDT
CHAIRMAN
4512 BISCAYNE DRIVE
VIRGINIA BEACH VA 23455-4202

Officer/Director/Trustee Two

BEN TRAPPEY
SECRETARY
3039 COLFAX AVE S
MINNEAPOLIS MN 55408

Officer/Director/Trustee Three

JENNIFER RAYNO
BOARD MEMBER
134 NORTH LASALLE STREET STE 500
CHICAGO IL 60602

Officer/Director/Trustee Four

MICHAEL KOSTER
BOARD MEMBER
593 EDDY STREET
PROVIDENCE RI 02903

Officer/Director/Trustee Five

JACQUELINE GAUTIER
BOARD MEMBER
4512 BISCAYNE DR
VIRGINIA BEACH VA 23455-4202

Organization’s website WWW.STDAMIENCOLLABORATIVE.ORG
Organization’s email JIM.SCHMIDT@STDAMIENCOLLABORATIVE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/27/2017
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E11 - Single Organization Support
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 Yes
Conducting Activities Outside of United States Yes
Financial transactions with officers No
Unrelated Gross Income $1,000 or More Yes
Gaming Activity No
Disaster relief assistance Yes
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 JAMES SCHMIDT
Signature Title CHAIRMAN
Signature Date 12/3/2019

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