FORM 1023-EZ for DELTA MINERVA LIFE DEVELOPMENT CENTER INC

Field Data
EIN 11-3350128
Case Number EO-2020195-000615
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name DELTA MINERVA LIFE DEVELOPMENT CENTER INC
Organization’s Mailing Address PO BOX 402
City HICKSVILLE
State NY
ZIP 11802-0402
Accounting period End 12
Primary contact name KIRA BRYANT
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

KIRA BRYANT
CHAIRMAN
728 FRANKLIN ST
WESTBURY NY 11590

Officer/Director/Trustee Two

MICHELE VAN EYKEN
VICE CHAIRMAN
36 S PARK PL
AMITYVILLE NY 11701

Officer/Director/Trustee Three

ANGELA JOURDAIN
TREASURER
118 MANOR AVE
HEMPSTEAD NY 11550

Officer/Director/Trustee Four

GRACE BRYANT
FINANCIAL SECRETARY
728 FRANKLIN ST
WESTBURY NY 11590

Officer/Director/Trustee Five

KERIA BLUE
SECRETARY
36 CATHEDRAL AVE APT 5E
HEMPSTEAD NY 11550

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/7/1996
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code S80 - Community Service Clubs
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 Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name KIRA BRYANT
Signature Title CHAIRMAN
Signature Date 7/9/2020

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