FORM 1023-EZ for LILY BROOK FARM

Field Data
EIN 46-3204783
Case Number EO-2015041-000244
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LILY BROOK FARM
Organization’s Mailing Address 335 LITTLE FALLS RD
City HOLLIS CENTER
State ME
ZIP 04042
Accounting period End 5
Primary contact name NINA FULLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMES HOFFMAN
DIRECTOR
234 E 14TH ST
NYC NY 10004

Officer/Director/Trustee Two

LILY HOFFMAN
DIRECTOR
BX 230
NYC NY 10276

Officer/Director/Trustee Three

SARAH DAVIDSON
DIRECTOR
189 E 3RD ST
NYC NY 10009

Officer/Director/Trustee Four

NINA FULLER
DIRECTOR
335 LITTLE FALLS RD
HOLLIS CENTER ME 04032

Officer/Director/Trustee Five

SPENCER FULLER
DIRECTOR
29 COVE RD
FREEPORT ME 04032

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/20/2013
Organization Incorporation State ME
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F11 - Single Organization Support
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: No
Cruelty Prevention: Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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