| Field | Data |
|---|---|
| EIN | 47-5461200 |
| Case Number | EO-2018254-000129 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | BRENDON P COUSINO MED47 FOUNDATIONINC |
| Organization’s Mailing Address | 31 HILLSIDE DRIVE |
| City | WILLISTON |
| State | VT |
| ZIP | 5495 |
| Accounting period End | 12 |
| Primary contact name | MARK R PERKELL |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
ZACHARY COUSINO
DIRECTOR
31 HILLSIDE DRIVE
WILLISTON VT 5495
JULIE GOODALL
DIRECTOR
67 BARRETT STEET
SOUTH BURLINGTON VT 5403
JACOB AUSTIN
DIRECTOR
6 SHORT STREET APT 3
:BARRE VT 5641
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/29/15 |
| Organization Incorporation State | VT |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | T12 - Fund Raising and/or Fund Distribution |
| 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 | Yes |
| One Third Support Gifts | No |
| Benefit of College | No |
| Private Foundation 508(e) | No |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | Yes |
| Correctness Declaration | Yes |
| Signature Name | ZACHARY COUSINO |
| Signature Title | DIRECTOR |
| Signature Date | 9/9/18 |
| EIN | 47-5461200 |
| Case Number | EO-2018254-000129 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | BRENDON P COUSINO MED47 FOUNDATION INC |
| Organization’s Mailing Address | 31 HILLSIDE DRIVE |
| City | WILLISTON |
| State | VT |
| ZIP | 5495 |
| Accounting period End | 12 |
| Primary contact name | MARK R PERKELL |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
ZACHARY COUSINO
DIRECTOR
31 HILLSIDE DRIVE
WILLISTON VT 5495
JULIE GOODALL
DIRECTOR
67 BARRETT STEET
SOUTH BURLINGTON VT 5403
JACOB AUSTIN
DIRECTOR
6 SHORT STREET APT 3
:BARRE VT 5641
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/29/15 |
| Organization Incorporation State | VT |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | T12 - Fund Raising and/or Fund Distribution |
| 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 | Yes |
| One Third Support Gifts | No |
| Benefit of College | No |
| Private Foundation 508(e) | No |
| Seeking Retroactive Reinstatement | No |
| Seeking Section 7 Reinstatement | Yes |
| Correctness Declaration | Yes |
| Signature Name | ZACHARY COUSINO |
| Signature Title | DIRECTOR |
| Signature Date | 9/9/18 |
| EIN | 47-5461200 |
| Case Number | EO-2016244-000304 |
| Form 1023-EZ version | 62014 |
| Eligibility Worksheet | 1 |
| Organization Name | BRENDON P COUSINO MED47 FOUNDATIONINC |
| Organization’s Mailing Address | 31 HILLSIDE DRIVE |
| City | WILLISTON |
| State | VT |
| ZIP | 05495 |
| Accounting period End | 12 |
| Primary contact name | MARK R PERKELL |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
ZACHARY COUSINO
DIRECTOR
31 HILLSIDE DRIVE
WILLISTON VT 05495
JULIE QUINTIN
DIRECTOR
67 BARRETT ST
SOUTH BURLINGTON VT 05403
JACOB AUSTIN
DIRECTOR
6 SHORT STREET APT 3
BARRE VT 05641
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 10/29/2015 |
| Organization Incorporation State | VT |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | T12 - Fund Raising and/or Fund Distribution |
| 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 | Yes |
| One Third Support Gifts | No |
| Benefit of College | No |
| Private Foundation 508(e) | No |
| Seeking Retroactive Reinstatement | Yes |
| Seeking Section 7 Reinstatement | No |
| Correctness Declaration | Yes |
| Signature Name | |
| Signature Title | |
| Signature Date |
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