FORM 1023-EZ for THE FITZPATRICK COLLABORATIVE INC

Field Data
EIN 83-0743119
Case Number EO-2018206-000349
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE FITZPATRICK COLLABORATIVE INC
Organization’s Mailing Address 5 LONGMEADOW LANE
City PEPPERELL
State MA
ZIP 1463-1440
Accounting period End 12
Primary contact name CRAIG R HANSEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CRAIG HANSEN
PRESIDENT, CEO, DIRECTOR
5 LONGMEADOW LANE
PEPPERELL MA 1463-1440

Officer/Director/Trustee Two

AMANDA HUNTINGTON
SECRETARY, COO, DIRECTOR
6 TUCKER AVENUE
PEPPERELL MA 1463

Officer/Director/Trustee Three

STEVEN TEMPLE
TREASURER, CFO, DIRECTOR
91A HARBOR STREET
PEPPERELL MA 1463

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/1/18
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N31 - Community Recreational Centers
Organization’s purpose Charitable: Yes
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 Yes
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 CRAIG HANSEN
Signature Title PRESIDENT, CEO, DIRECTOR
Signature Date 7/23/18

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