FORM 1023-EZ for THE BIRCH HOUSE

Field Data
EIN 83-3649864
Case Number EO-2019136-000431
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE BIRCH HOUSE
Organization’s Mailing Address 13 WALL STREET
City GLOUCESTER
State MA
ZIP 1930-3069
Accounting period End 12
Primary contact name CYNTHIA MOCHOWSKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CYNTHIA MOCHOWSKI
PRESIDENT, DIRECTOR
13 WALL STREET
GLOUCESTER MA

Officer/Director/Trustee Two

HELEN DENHAM
TREASURER, DIRECTOR
13 WALL STREET
GLOUCESTER MA

Officer/Director/Trustee Three

CARLA ORR
CLERK, DIRECTOR
13 WALL STREET
GLOUCESTER MA

Officer/Director/Trustee Four

DAWN ARTHMANN
DIRECTOR
13 WALL STREET
GLOUCESTER MA

Officer/Director/Trustee Five

VALERIE KIRR
DIRECTOR
13 WALL STREET
GLOUCESTER MA

Organization’s website N/A
Organization’s email CYNMOCHO@AOL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/13/19
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B01 - Alliance/Advocacy Organizations
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 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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name CYNTHIA MOCHOWSKI
Signature Title PRESIDENT, DIRECTOR
Signature Date 5/14/19

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