FORM 1023-EZ for GYPSY DINER

Field Data
EIN 47-4580082
Case Number EO-2015205-000419
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name GYPSY DINER
Organization’s Mailing Address 184 PURCHASE ST
City MILFORD
State MA
ZIP 01757-1117
Accounting period End 12
Primary contact name ROBIN A CAPUTO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

STEPHEN CAPUTO
CHAIR
184 PURCHASE ST
MILFORD MA 01757-1117

Officer/Director/Trustee Two

ROBIN CAPUTO
TREASURER
184 PURCHASE ST
MILFORD MA 01757-1117

Officer/Director/Trustee Three

AMANDA ADAMS
VICE-CHAIR
63 FREETOWN STREET CARRIAGE HOUSE
LAKEVILLE MA 02347-2222

Officer/Director/Trustee Four

PAULINE PALLADINO
SECRETARY
7 POCASSET ST
WORCESTER MA 01604-2016

Organization’s website
Organization’s email GYPSYDINER@GMAIL.COM
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/21/2015
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code K30 - Food Service, Free Food Distribution Programs
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 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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