FORM 1023-EZ for K9 KNIGHTS OF SOUTHAMPTON NY INC

Field Data
EIN 83-0565217
Case Number EO-2018155-000235
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name K9 KNIGHTS OF SOUTHAMPTON NY INC
Organization’s Mailing Address 485 MADISON AVE
City NEW YORK
State NY
ZIP 10022
Accounting period End 12
Primary contact name NICHOLAS VERBITSKY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

NICHOLAS VERBITSKY
DIRECTOR
485 MADISON AVENUE
NEW YORK NY 10017

Officer/Director/Trustee Two

BONITA VERBITSKY
DIRECTOR
485 MADISON AVENUE
NEW YORK NY 10017

Officer/Director/Trustee Three

KRISTIN VERBITSKY
DIRECTOR
485 MADISON AVENUE
NEW YORK NY 10017

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/30/18
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code I60 - Law Enforcement Agencies (Police Departments)
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name NICHOLAS VERBITSKY
Signature Title DIRECTOR
Signature Date 5/31/18

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