FORM 1023-EZ for SUSQUEHANNA COUNTY RECREATION CENTER

Field Data
EIN 47-1847845
Case Number EO-2016014-000384
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SUSQUEHANNA COUNTY RECREATION CENTER
Organization’s Mailing Address 13763 STATE ROUTE 92
City SOUTH GIBSON
State PA
ZIP 18842
Accounting period End 12
Primary contact name ASHLEY L KILMER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ASHLEY KILMER
PRESIDENT
13763 STATE ROUTE 92
SOUTH GIBSON PA 18842

Officer/Director/Trustee Two

MATTHEW BUTTON
TREASURER
5058 SCHOOL ROAD
NEW MILFORD PA 18834

Officer/Director/Trustee Three

MARISSA MCANDREW
SECRETARY
4 CHESTNUT STREET
MONTROSE PA 18801

Officer/Director/Trustee Four

THERESE NICHOLS-WISE
MEMBER
53 W LAKE SHORE DRIVE
TUNKHANNOCK PA 18657

Officer/Director/Trustee Five

ADAM DIAZ
MEMBER
7686 PA 167
KINGSLEY PA 18826

Organization’s website HTTP://WWW.SUSCOREC.ORG
Organization’s email ALKILMER_32@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/15/2014
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N31 - Community Recreational Centers
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
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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