FORM 1023-EZ for AMPUTEE ASSOCIATION OF MAINE

Field Data
EIN 47-5326802
Case Number EO-2016049-000137
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name AMPUTEE ASSOCIATION OF MAINE
Organization’s Mailing Address 202 US ROUTE ONE
City FALMOUTH
State ME
ZIP 04105
Accounting period End 12
Primary contact name ROBERT E DANIELSON ESQ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JOHN LEMIEUX
PRESIDENT
202 US ROUTE ONE
FALMOUTH ME 04105

Officer/Director/Trustee Two

STEPHEN JORDAN
VICE PRESIDENT
9 CODMAN ST
PORTLAND ME 04101

Officer/Director/Trustee Three

P MICHAEL NORDMAN
DIRECTOR
26 FIELD CREST DRIVE
GORHAM ME 04038

Officer/Director/Trustee Four

ERIC ANTON
DIRECTOR
98 BLACKSTRAP ROAD
FALMOUTH ME 04105

Officer/Director/Trustee Five

CATHERINE WYGANT FOSSETT
DIRECTOR
18 TOWNSEND LANE
BOOTHBAY ME 04537

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/17/2014
Organization Incorporation State ME
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B01 - Alliance/Advocacy Organizations
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 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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