FORM 1023-EZ for SISTERHOOD OF BLESSED KSENIA INC

Field Data
EIN 38-3821978
Case Number EO-2014350-000214
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SISTERHOOD OF BLESSED KSENIA INC
Organization’s Mailing Address 40 NORTH CONGER AVENUE
City CONGERS
State NY
ZIP 10920
Accounting period End 12
Primary contact name TATIANA RUSIECKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

TATIANA RUSIECKI
PRESIDENT
40 NORTH CONGER AVENUE
CONGERS NY 10920

Officer/Director/Trustee Two

TATIANA RODZIANKO
TREASURER
252 ROCKLAND LAKE ROAD
VALLEY COTTAGE NY 10989

Officer/Director/Trustee Three

MARINA PETRONI
SECRETARY
213 MAIN STREET
NEW CITY NY 10956

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/19/2010
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code X20 - Christian
Organization’s purpose Charitable: Yes
Religious: Yes
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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