FORM 1023-EZ for PATIENT RESOLUTIONS INC

Field Data
EIN 47-5386131
Case Number EO-2015310-000343
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name PATIENT RESOLUTIONS INC
Organization’s Mailing Address 131 CENTER STREET
City LUDLOW
State MA
ZIP 01056
Accounting period End 12
Primary contact name LISA CROUSER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LISA CROUSER
PRESIDENT
1000 TINKHAM RD
WILBRAHAM MA 01095

Officer/Director/Trustee Two

ELLEN NUTTER
TREASURER
891 BRADLEY RD
SPRINGFIELD MA 01109

Officer/Director/Trustee Three

LESLIE MALERBI
CLERK
48 GARRETT RD
NO SCITUATE MA 02066

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/13/2015
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E80 - Health, General and Financing
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 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
Signature Title
Signature Date

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