FORM 1023-EZ for JUDY REVIS CHILDRENS HOSPICE INC

Field Data
EIN 47-4464597
Case Number EO-2015198-000357
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JUDY REVIS CHILDRENS HOSPICE INC
Organization’s Mailing Address 500 ATLANTIC AVE UNIT 15J
City BOSTON
State MA
ZIP 02210
Accounting period End 12
Primary contact name KENNETH REVIS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TAMARA VESEL
PRESIDENT
49 JUDKINS ST
NEWTON MA 02460

Officer/Director/Trustee Two

KENNETH REVIS
SECRETARY/TREASURER
500 ATLANTIC AVE UNIT 15J
BOSTON MA 02210

Officer/Director/Trustee Three

JOEL ABRAMS
BOARD MEMBER
17 TANGLEWOOD DR
CONCORD MA 01742

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/10/2015
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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 Yes
One Third Support Gifts No
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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