FORM 1023-EZ for DEMENTIA FRIENDLY COMMUNITY COALITION INC

Field Data
EIN 82-2160421
Case Number EO-2017243-000114
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DEMENTIA FRIENDLY COMMUNITY COALITION INC
Organization’s Mailing Address N3851 BONEHAM ADDITION ROAD
City MARINETTE
State WI
ZIP 54143
Accounting period End 12
Primary contact name PAMALA J DAYE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MEGHAN RUTHERFORD
PRESIDENT
831 PINE BEACH ROAD
MARINETTE WI 54143

Officer/Director/Trustee Two

JUNE EHLERS
VICE PRESIDENT
470 E FRONT STREET
PESHTIGO WI 54157

Officer/Director/Trustee Three

PAMALA DAYE
SECRETARY
N3851 BONEHAM ADDITION ROAD
MARINETTE WI 54143

Officer/Director/Trustee Four

JAMIE DUDEK
TREASURER
516 N HIGHWAY 141
CRIVITZ WI 54114

Officer/Director/Trustee Five

MARILYNN GALINEAU
MEMBER AT LARGE
115 HATTIE STREET
MARINETTE WI 54143

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/15/2017
Organization Incorporation State WI
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E01 - 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 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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