FORM 1023-EZ for OCEAN COUNTY SHRINE LADIES CLUB

Field Data
EIN 84-2488835
Case Number EO-2019206-000191
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name OCEAN COUNTY SHRINE LADIES CLUB
Organization’s Mailing Address 36 CHARLEN ROAD
City TOMS RIVER
State NJ
ZIP 8755
Accounting period End 12
Primary contact name DONNA CARBONE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LYNN BALL
PRESIDENT
82 BIABOU DRIVE
TOMS RIVER NJ 8757

Officer/Director/Trustee Two

CARRIE ETZEL
VICE PRESIDENT
311 PARADISE POINT WAY
FORKED RIVER NJ 8731

Officer/Director/Trustee Three

LORRAINE GOWEN
SECRETARY
1013 ORLANDO DRIVE
FORKED RIVER NJ 8731

Officer/Director/Trustee Four

DONNA CARBONE
TREASURER
36 CHARLEN ROAD
TOMS RIVER NJ 8755

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/13/01
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T12 - 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name DONNA CARBONE
Signature Title TREASURER
Signature Date 7/23/19

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