FORM 1023-EZ for CARL G ANDERSON EDUCATIONAL TRUST FUND

Field Data
EIN 58-2673404
Case Number EO-2017048-000107
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CARL G ANDERSON EDUCATIONAL TRUST FUND
Organization’s Mailing Address 49 BUTTONBALL ROAD
City OLD LYME
State CT
ZIP 06371
Accounting period End 12
Primary contact name NANCY TIFFANY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

RANDALL CLEGG
TRUSTEE
16 HILLTOP AVE
ESSEX CT 06426

Officer/Director/Trustee Two

JAMES KELLY
TRUSTEE
10 HALL AVE
NEW LONDON CT 06320

Officer/Director/Trustee Three

GREGORY KELLY
TRUSTEE
19 MERIDEN ROAD
OLD LYME CT 06371

Officer/Director/Trustee Four

JEFFREY SCULL
TRUSTEE
1 POINT ROAD
NIANTIC CT 06357

Officer/Director/Trustee Five

STEPHAN BRODEUR
TRUSTEE
5 OLD COLONY ROAD
OLD SAYBROOK CT 06475

Organization’s website
Organization’s email
Organization Incorporated
Organization trust Yes
Necessary Organizing Documents Yes
Organization Incorporation Date 7/1/2003
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B82 - Scholarships, Student Financial Aid Services, Awards
Organization’s purpose Charitable: No
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
Signature Title
Signature Date

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