FORM 1023-EZ for MINDFUL HARLEM

Field Data
EIN 47-1644843
Case Number EO-2014364-000295
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MINDFUL HARLEM
Organization’s Mailing Address 327 W 112 APT 2
City NEW YORK
State NY
ZIP 10026
Accounting period End 12
Primary contact name JAYNE GUMPEL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAYNE GUMPEL
DIRECTOR OFFICER
229 E 48 APT 1
NEW YORK NY 10017

Officer/Director/Trustee Two

ADRIAN BUENO
CO DIRECTOR OFFICER
327 W 112 APT 2
NEW YORK NY 10026

Officer/Director/Trustee Three

FAY LEEPER
BOARD MEMBER AND SECRETARY
711 AMSTERDAM
NEW YORK NY 10028

Organization’s website WWW.MINDFULHARLEM.ORG
Organization’s email TALK2US@MINDFULHARLEM.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/31/2014
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E99 - Health - General and Rehabilitative N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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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