FORM 1023-EZ for ROCKLAND CHILDRENS PSYCHIATRIC CENTER FOUNDATION INC

Field Data
EIN 13-3946876
Case Number EO-2014336-000463
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ROCKLAND CHILDRENS PSYCHIATRIC CENTER FOUNDATION INC
Organization’s Mailing Address C/O SKELLY 32 CYPRESS ST
City NEW CITY
State NY
ZIP 10956
Accounting period End 3
Primary contact name RONALD SMITH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MICHAEL SKELLY
PRESIDENT
32 CYPRESS ST
NEW CITY NY 10956

Officer/Director/Trustee Two

RONALD SMITH
TREASURER
3 KELLY COURT
TOMKINS COVE NY 10986-1403

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/27/1984
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code F12 - Fund Raising and/or Fund Distribution
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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