FORM 1023-EZ for COMMUNITY COLLABORATIVE FOR GUILFORD INC

Field Data
EIN 47-3753932
Case Number EO-2015331-000209
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COMMUNITY COLLABORATIVE FOR GUILFORD INC
Organization’s Mailing Address 38 CHURCH DRIVE
City GUILFORD
State VT
ZIP 05301
Accounting period End 12
Primary contact name JAMES L HAINE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMES HAINE
DIRECTOR
2068 STAGE RD
GUILFORD VT 05301

Officer/Director/Trustee Two

BEN COPLAN
DIRECTOR
56 MARLBORO AVE
BRATTLEBORO VT 05301

Officer/Director/Trustee Three

ELLEN MAJOREN
DIRECTOR
35 MARYNUK RD
GUILFORD VT 05301

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/2/2015
Organization Incorporation State VT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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