FORM 1023-EZ for HAILE CLACKEN BIPOLAR FOUNDATION INC

Field Data
EIN 82-4379350
Case Number EO-2018068-000197
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HAILE CLACKEN BIPOLAR FOUNDATION INC
Organization’s Mailing Address PO BOX 294
City FRANKLIN SQUARE
State NY
ZIP 11010-294
Accounting period End 12
Primary contact name LILIETH CLACKEN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

LILIETH CLACKEN
PRESIDENT, CHAIRPERSON, DIRECTOR
PO BOX 294
FRANKLIN SQUARE NY 11010-294

Officer/Director/Trustee Two

DELVER CHARLERY
TREASURER, DIRECTOR
PO BOX 294
FRANKLIN SQUARE NY 11010-294

Officer/Director/Trustee Three

CHERYLL BARRETT
SECRETARY, DIRECTOR
PO BOX 294
FRANKLIN SQUARE NY 11010-294

Officer/Director/Trustee Four

VALDA SHAKESPEARE
VICE PRESIDENT, DIRECTOR
PO BOX 294
FRANKLIN SQUARE NY 11010-294

Officer/Director/Trustee Five

DELIVETTE CASTOR
DIRECTOR
PO BOX 294
FRANKLIN SQUARE NY 11010-294

Organization’s website
Organization’s email HCBIPOLARFOUNDATION@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/6/18
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
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 Yes
Conducting Activities Outside of United States Yes
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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name LILIETH CLACKEN
Signature Title PRESIDENT, CHAIRPERSON, DIRECTOR
Signature Date 3/7/18

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