FORM 1023-EZ for THE PEOPLES CLINIC INC

Field Data
EIN 82-2094506
Case Number EO-2017193-000346
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name THE PEOPLES CLINIC INC
Organization’s Mailing Address 2 ENTERPRISE DR STE 412
City SHELTON
State CT
ZIP 06484
Accounting period End 12
Primary contact name JACQUELINE BONILLA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JACQUELINE BONILLA
PRESIDENT, DIRECTOR
2 ENTERPRISE DR STE 412
SHELTON CT 06484

Officer/Director/Trustee Two

IVELISSE SANCHEZ
SECRETARY, DIRECTOR
2 ENTERPRISE DR STE 412
SHELTON CT 06484

Officer/Director/Trustee Three

ESMERALDA NIEVES
TREASURER, DIRECTOR
2 ENTERPRISE DR STE 412
SHELTON CT 06484

Organization’s website N/A
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/23/2017
Organization Incorporation State CT
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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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