FORM 1023-EZ for GLENDIVE COMMUNITY CANCER FUND

Field Data
EIN 47-1977296
Case Number EO-2014344-000339
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GLENDIVE COMMUNITY CANCER FUND
Organization’s Mailing Address 310 GEORGETOWN DRIVE
City GLENDIVE
State MT
ZIP 59330
Accounting period End 12
Primary contact name CAROLE DICK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

VERNA BAISCH
DIRECTOR
15 CACTUS LANE
GLENDIVE MT 59330

Officer/Director/Trustee Two

BETTY MAWBEY
DIRECTOR
1217 WEST BELL LOT 72
GLENDIVE MT 59330

Officer/Director/Trustee Three

DAWN GUENZI
DIRECTOR
726 EAST TOWNE STREET
GLENDIVE MT 59330

Officer/Director/Trustee Four

CAROLE DICK
DIRECTOR
310 GEORGETOWN DRIVE
GLENDIVE MT 59330

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/1/2014
Organization Incorporation State MT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E12 - Fund Raising and/or Fund Distribution
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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