FORM 1023-EZ for SERENITY FOUNDATION INC

Field Data
EIN 43-2071060
Case Number EO-2015141-000287
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SERENITY FOUNDATION INC
Organization’s Mailing Address 88-30 51ST AVENUE APARTMENT 4D
City ELMHURST
State NY
ZIP 11373-3995
Accounting period End 12
Primary contact name ALBERT JUSZCZAK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ALBERT JUSZCZAK
PRESIDENT TRUSTEE
88-30 51ST AVENUE APT 4D
ELMHURST NY 11373-3995

Officer/Director/Trustee Two

MARK JUSZCZAK
TREASURER TRUSTEE
402 N BIRMINGHAM AVENUE
AVALON PA 15202-2434

Officer/Director/Trustee Three

JANINA JUSZCZAK
CHAIRPERSON VICE PRESIDENT
88-30 51ST AVENUE APT 4D
ELMHURST NY 11373-3995

Officer/Director/Trustee Four

THERESA JACKSON
SECRETARY TRUSTEE
32-39 92ND STREET
EAST ELMHURST NY 11369-2441

Organization’s website WWW.PEACEHOPEYOGA.COM
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/10/2004
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X99 - Religion Related, Spiritual Development N.E.C.
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
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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