FORM 1023-EZ for ALZHEIMERS CONVERSATION PROJECT INC

Field Data
EIN 82-2007188
Case Number EO-2018109-000587
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ALZHEIMERS CONVERSATION PROJECT INC
Organization’s Mailing Address 5582 WELLESLEY PARK DRIVE APT 301
City BOCA RATON
State FL
ZIP 33433
Accounting period End 12
Primary contact name DONNA RAPHAEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DONNA RAPHAEL
PRESIDENT/PROGRAM DIRECTOR
5582 WELLESLEY PARK DRIVE APT 301
BOCA RATON FL 33433

Officer/Director/Trustee Two

PATRICIA JONES
SECRETARY
935 ST NICHOLAS AVENUE
NEW YORK NY 10032

Officer/Director/Trustee Three

GARTH MARTIN
TREASURER
5582 WELLESLEY PARK DRIVE APT 301
BOCA RATON FL 33433

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/29/17
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G83 - Alzheimer's Disease
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 DONNA RAPHAEL
Signature Title PRESIDENT/PROGRAM DIRECTOR
Signature Date 4/17/18

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