COMMUNITY BENEFITS REPORTING FORM
Pursuant to RSA 7:32-c-l

FOR FISCAL YEAR BEGINNING 07/01/2008

to be filed with:
Office of the Attorney General
Charitable Trusts Unit
33 Capitol Street, Concord, NH 03301-6397
603-271-3591

Section 1: ORGANIZATIONAL INFORMATION

Organization Name: Manchester Community Health Center

Street Address 145 Hollis Street

City Manchester County 06– Hillsborough State NH Zip Code 03101

Federal ID # - 20458174 State Registration # 5052

Website Address: www.mchc-nh.org

Is the organization’s community benefit plan on the organization’s website? YES

Has the organization filed its Community Benefits Plan Initial Filing Information form? YES

IF NO, please complete and attach the Initial Filing Information Form.
IF YES, has any of the initial filing information changed since the date of submission?

IF YES, please attach the updated information.

Chief Executive: Edward G. George 6036269500 egeorge@mchc-nh.org

Board Chair: Richard Samuels 6036281470 rsamuels@mclane.com

Community Benefits
Plan Contact: Edward G. George 6036269500 egeorge@mchc-nh.org

Is this report being filed on behalf of more than one health care charitable trust? NO

IF YES, please complete a copy of this page for each individual organization included in this filing.