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If different from legal
Executive Director
Name, Email Address, Phone Number
{name}
Fiduciary Contact
Name, Email Address, Phone Number
{name}
Board Treasurer
Name, Email Address, Phone Number
{name}
Other Board Member(s)
Name
N, EZ, 990, ETC
Number of Employees on Payroll
{name}
State Registered
List of states, start date, and entity name below
{name}
If in Orleans, do you have an occupational license?
List below if other
Upload your 501c(3) exemption form here
Attach file
Drop files here
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