FORM 1023-EZ for RESTORATIVE COMMUNITY JUSTICE FOR SOUTHERN VERMONT

Field Data
EIN 81-5198497
Case Number EO-2017034-000147
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name RESTORATIVE COMMUNITY JUSTICE FOR SOUTHERN VERMONT
Organization’s Mailing Address 2042 VT RT 39
City TOWNSHEND
State VT
ZIP 05353
Accounting period End 2
Primary contact name DAN DEWALT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DAN DEWALT
PRESIDENT
52 PARISH HILL
SOUTH NEWFANE VT 05351-0017

Officer/Director/Trustee Two

GARY KEISER
BOARD MEMBER
204 DOVER ROAD
WILLIAMSVILLE VT 05346

Officer/Director/Trustee Three

AYAR HEMPHILL
BOARD MEMBER
23 PARISH HILL
SOUTH NEWFANE VT 05351

Officer/Director/Trustee Four

PHOEBE CONNOLLY
SECRETARY
24 HEMLOCK HILL ROAD
NEWFANE VT 05345

Officer/Director/Trustee Five

LISA NASH
TRESURER
101 SULLIVAN DRIVE
PUTNEY VT 05346

Organization’s website WWW.RCJSV.ORG
Organization’s email RCJSVT@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/13/2016
Organization Incorporation State VT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S99 - Community Improvement, Capacity Building N.E.C.
Organization’s purpose Charitable: No
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 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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