FORM 1023-EZ for GOSHEN COMMUNITY TELEHEALTH INC

Field Data
EIN 85-4280430
Case Number EO-2021063-000387
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name GOSHEN COMMUNITY TELEHEALTH INC
Organization’s Mailing Address 9904 KNOX DRIVE
City OVERLAND PARK
State KS
ZIP 66212
Accounting period End 12
Primary contact name MONICA KANGETHE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MONICA KANGETHE
PRESIDENT
9904 KNOX DRIVE
OVERLAND PARK KS 66212

Officer/Director/Trustee Two

BENSON KANGETHE
TREASURER
9904 KNOX DRIVE
OVERLAND PARK KS 66212

Officer/Director/Trustee Three

EVAH RIUNGU
CHAIRPERSON
9904 KNOX DRIVE
OVERLAND PARK KS 66212

Officer/Director/Trustee Four

JANETTE JASPERSON
DIRECTOR
9904 KNOX DRIVE
OVERLAND PARK KS 66212

Officer/Director/Trustee Five

JAMES NJUGUNA
DIRECTOR
9904 KNOX DRIVE
OVERLAND PARK KS 66212

Organization’s website
Organization’s email GOSHENCOMMUNITYTELEHEALTHINC@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/14/2020
Organization Incorporation State KS
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E90 - Nursing Services (General)
Organization’s purpose Charitable: Yes
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 Yes
Donation of funds No
Conducting Activities Outside of United States Yes
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 MONICA KANGETHE
Signature Title PRESIDENT
Signature Date 12/28/2020

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