FORM 1023-EZ for ADAPTIVELY ABLED AMPUTEES INC

Field Data
EIN 84-2142773
Case Number EO-2019249-000117
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ADAPTIVELY ABLED AMPUTEES INC
Organization’s Mailing Address 1 BROADWAY SUITE 2
City ARLINGTON
State MA
ZIP 2474
Accounting period End 12
Primary contact name GLENN MEURER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MELISSA DECHELLIS
PRESIDENT CEO DIRECTOR
109 WATER ST 305
BEVERLY MA 1915

Officer/Director/Trustee Two

MICHAEL DECHELLIS
TREASURER DIRECTOR
109 WATER ST 305
BEVERLY MA 1915

Officer/Director/Trustee Three

GLENN MEURER
VICE PRESIDENT DIRECTOR
1 PARKER CIR
WESTFORD MA 1886

Officer/Director/Trustee Four

ALEC MCMANUS
CLERK DIRECTOR
61 HIGH ST APT 3
WALTHAM MA 2453

Officer/Director/Trustee Five

ERIK KONDO
DIRECTOR
956 MASSACHUSETTS AVE
LEXINGTON MA 2420

Organization’s website WWW.ADAPTIVELYABLEDAMPUTEES.ORG
Organization’s email ADAPTIVELYABLEDAMPUTEES@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/11/19
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N50 - Recreational, Pleasure, or Social Club
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 GLENN MEURER
Signature Title VICE PRESIDENT DIRECTOR
Signature Date 9/3/19

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