FORM 1023-EZ for TO BE DETERMINED

Field Data
EIN 46-1800928
Case Number EO-2014364-000292
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name TO BE DETERMINED
Organization’s Mailing Address 126 CLIFTON PLACE SUITE 306
City JERSEY CITY
State NJ
ZIP 07304
Accounting period End 6
Primary contact name TONY HARRINGTON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TONY HARRINGTON
TRUSTEE
126 CLIFTON PLACE APARTMENT 306
JERSEY CITY NJ 07304

Officer/Director/Trustee Two

MARY WEST
TRUSTEE
115-34 219TH STREET
CAMBRIA HEIGHTS NY 11411

Officer/Director/Trustee Three

IBBIN HAMILTON
TRUSTEE
627 SUMMIT AVENUE APARTMENT 5G
JERSEY CITY NJ 07306

Officer/Director/Trustee Four

KAREN WEST
TRUSTEE
115-34 219TH STREET
CAMBRIA HEIGHTS NY 11411

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/6/2014
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X19 - Nonmonetary Support N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: No
Scientific: No
Literary: No
Public Safety: Yes
Amateur Sports: No
Cruelty Prevention: No
Qualify For Exemption No
Legislation influence No
Compensation of Officer director trustee No
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers No
Unrelated Gross Income $1,000 or More No
Gaming Activity Yes
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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