FORM 1023-EZ for PIECE BY PIECE BETHPAGE INC

Field Data
EIN 81-3525941
Case Number EO-2021028-000246
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PIECE BY PIECE BETHPAGE INC
Organization’s Mailing Address 27 LEXINGTON AVENUE
City BETHPAGE
State NY
ZIP 11714
Accounting period End 6
Primary contact name CHARLES GALLO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JEAN SHELTON
DIRECTOR
27 LEXINGTON AVENUE
BETHPAGE NY 11714

Officer/Director/Trustee Two

KEVIN CLYNE
DIRECTOR
538 BROADHOLLOW ROAD STE 307
MELVILLE NY 11747

Officer/Director/Trustee Three

DIANE MCCLAIN
DIRECTOR
2880 RIVERSIDE DRIVE
WANTAGH NY 11793

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/21/2016
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P40 - Family Services
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 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 No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JEAN SHELTON
Signature Title DIRECTOR
Signature Date 12/14/2020

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