FORM 1023-EZ for MOOSE AND JANET MILLER CAMPERSHIP FUND INC

Field Data
EIN 47-5480806
Case Number EO-2017079-000320
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MOOSE AND JANET MILLER CAMPERSHIP FUND INC
Organization’s Mailing Address 11 CAMP ROAD
City ORFORD
State NH
ZIP 03777
Accounting period End 12
Primary contact name AL SAMOR
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SUSAN MILLER HILD
PRESIDENT
37 LONG VIEW ROAD
WEST HARTFORD CT 06107

Officer/Director/Trustee Two

JUDITH MILLER
TREASURER
48 UPPER BAKER POND
ORFORD NH 03777

Officer/Director/Trustee Three

GARY MILLER
DIRECTOR
48 UPPER BAKER POND
ORFORD NH 03777

Officer/Director/Trustee Four

GREGORY MILLER
DIRECTOR
56 LOCKWOOD AVE
OLD GREENWICH CT 06870

Officer/Director/Trustee Five

MARK MILLER
DIRECTOR
355 SOUTH 100 WEST
HEBER UT 84032

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/31/2016
Organization Incorporation State NH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 -
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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