FORM 1023-EZ for DEL PUERTO HOSPITAL FOUNDATION

Field Data
EIN 94-2786961
Case Number EO-2019303-000466
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DEL PUERTO HOSPITAL FOUNDATION
Organization’s Mailing Address PO BOX 187
City PATTERSON
State CA
ZIP 95363
Accounting period End 6
Primary contact name KARIN HENNINGS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

STEVE PITTSON
PRESIDENT
875 E STREET
PATTERSON CA 95363-2670

Officer/Director/Trustee Two

DANIEL ROBINSON
VICE PRESIDENT
875 E STREET
PATTERSON CA 95363-2670

Officer/Director/Trustee Three

BECKY CAMPO
SECRETARY
875 E STREET
PATTERSON CA 95363-2670

Officer/Director/Trustee Four

ANNE STOKMAN
TREASURER
875 E STREET
PATTERSON CA 95363-2670

Officer/Director/Trustee Five

KARIN HENNINGS
ADMINISTRATIVE DIRECTOR
875 E STREET
PATTERSON CA 95363-2670

Organization’s website
Organization’s email KARIN.HENNINGS@DPHEALTH.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/31/81
Organization Incorporation State CA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E12 - 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 KARIN HENNINGS
Signature Title ADMINISTRATIVE DIRECTOR
Signature Date 10/28/19

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