FORM 1023-EZ for CAMILLES PLACE INC

Field Data
EIN 86-1352019
Case Number EO-2021077-000181
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CAMILLES PLACE INC
Organization’s Mailing Address 546 SOUTH BROAD STREET SUITE 3C
City MERIDEN
State CT
ZIP 06450-6601
Accounting period End 12
Primary contact name CAMILLE PAYNE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

CAMILLE PAYNE
PRESIDENT
546 SOUTH BROAD ST STE 3C
MERIDEN CT 06450-6601

Officer/Director/Trustee Two

INGRID BEECH
TREASURER
33 JEROME AVENUE
MERIDEN CT 06450-6906

Officer/Director/Trustee Three

QUINITA PITTS
SECRETARY
51 STONEWALL LANE
WATERBURY CT 06705-3475

Officer/Director/Trustee Four

TERRELL PITTS
CO-SECRETARY
51 STONEWALL LANE
WATERBURY CT 06705-3475

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/6/2021
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E99 - Health - General and Rehabilitative N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: Yes
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 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 CAMILLE PAYNE
Signature Title PRESIDENT
Signature Date 1/20/2021

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