FORM 1023-EZ for COMMUNITY NURSE OF THETFORD

Field Data
EIN 47-3969957
Case Number EO-2016286-000264
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COMMUNITY NURSE OF THETFORD
Organization’s Mailing Address 177 HAUGER ROAD
City THETFORD
State VT
ZIP 05075
Accounting period End 12
Primary contact name SARAH JO BROWN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SARAH JO BROWN
CHAIRMAN
177 HAUGER ROAD
THETFORD VT 05075

Officer/Director/Trustee Two

PRISCILLA HALL
SECRETARY
383 ROUTE 244
POST MILLS VT 05058

Officer/Director/Trustee Three

JOANNE SANDBERG-COOK
TREASURER
4397 ROUTE 113
THETFORD CENTER VT 05075

Officer/Director/Trustee Four

SUSAN FARRELL
DIRECTOR
PO BOX 206
THETFORD CENTER VT 05075

Officer/Director/Trustee Five

GAIL DIMICK
DIRECTOR
13 BORDER ST
ORFORD NH 03777

Organization’s website COMMUNITYNURSEOFTHETFORD@WEEBLY.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/20/2015
Organization Incorporation State VT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E70 - Public Health Program (Includes General Health and Wellness Promotion Services)
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 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
Signature Title
Signature Date

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