FORM 1023-EZ for POOLESVILLE AREA SENIOR CENTER INC

Field Data
EIN 81-2272507
Case Number EO-2016111-000230
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name POOLESVILLE AREA SENIOR CENTER INC
Organization’s Mailing Address 19721 BEALL STREET PO BOX 158
City POOLESVILLE
State MD
ZIP 20837
Accounting period End 12
Primary contact name WADE YOST
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CARL BRILL
PRESIDENT
PO BOX 158
POOLESVILLE MD 20837

Officer/Director/Trustee Two

RICHARD NORWOOD
TREASURER
PO BOX 158
POOLESVILLE MD 20837

Officer/Director/Trustee Three

MARIA BRIANCON
DIRECTOR
PO BOX 158
POOLESVILLE MD 20837

Officer/Director/Trustee Four

RAYMOND HOEWING
DIRECTOR
PO BOX 158
POOLESVILLE MD 20837

Officer/Director/Trustee Five

JACKIE KONKUS
DIRECTOR
PO BOX 158
POOLESVILLE MD 20837

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/28/2015
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P81 - Senior Centers, 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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