FORM 1023-EZ for MAINE LICENSED DENTURIST ASSOCIATION

Field Data
EIN 35-2416028
Case Number EO-2021148-000113
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MAINE LICENSED DENTURIST ASSOCIATION
Organization’s Mailing Address PO BOX 1921
City WINDHAM
State ME
ZIP 04062
Accounting period End 12
Primary contact name TANYA GRIFFETH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

TANYA GRIFFETH
MRS
451 WEBBS MILLS ROAD
RAYMOND ME 04071

Officer/Director/Trustee Two

JOE ADKINS
MR
801 WEBSTER STREET
LEWISTON ME 04240

Officer/Director/Trustee Three

LYNDSAY WOOD
MRS
487 PEQUAWKET TRL
STEEP FALLS ME 04085-6803

Officer/Director/Trustee Four

LINDA SOULIERE
MRS
202 MAPLE ST
CORNISH ME 04020

Organization’s website NEW SITE COMING SOON
Organization’s email MAINELDA2011@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/2011
Organization Incorporation State ME
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S41 - Promotion of Business
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 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 TANYA GRIFFETH
Signature Title MRS
Signature Date 5/20/2021

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