FORM 1023-EZ for MY LIFE SERIES FOUNDATION INC

Field Data
EIN 84-3326812
Case Number EO-2019288-000362
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name MY LIFE SERIES FOUNDATION INC
Organization’s Mailing Address 200 HIGHLAND STREET SUITE 1
City WORCESTER
State MA
ZIP 1609-2229
Accounting period End 12
Primary contact name HON MEL L GREENBERG RET
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DELMAR SHERRILL
PRESIDENT
16 DUXBURY DRIVE
HOLDEN MA 1520-1607

Officer/Director/Trustee Two

DELMAR SHERRILL
TREASURER
16 DUXBURY DRIVE
HOLDEN MA 1520-1607

Officer/Director/Trustee Three

GEORGE SHERRILL
VICE PRESIDENT
25 DEAN AVENUE
HOLDEN MA 1520

Officer/Director/Trustee Four

MEL GREENBERG
DIRECTOR
200 HIGHLAND STREET SUITE 1
WORCESTER MA 1609-2229

Officer/Director/Trustee Five

DELMAR SHERRILL
DIRECTOR
16 DUXBURY DRIVE
HOLDEN MA 1520-1607

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/20/19
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
Organization’s purpose Charitable: No
Religious: No
Educational: No
Scientific: No
Literary: Yes
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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MEL GREENBERG
Signature Title DIRECTOR
Signature Date 10/11/19

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