FORM 1023-EZ for ST BERNADETTE SCHOOL FAMILY FUND INC

Field Data
EIN 47-5180526
Case Number EO-2016109-000042
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name ST BERNADETTE SCHOOL FAMILY FUND INC
Organization’s Mailing Address 16 HAZELTINE RD
City UPTON
State MA
ZIP 01568-1533
Accounting period End 12
Primary contact name RON BIALOBRZESKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

RON BIALOBRZESKI
DIRECTOR
16 HAZELTINE RD
UPTON MA 01568-1533

Officer/Director/Trustee Two

DAVID BENNETT
DIRECTOR
10 FOX RUN RD
MEDWAY MA 02053-2242

Officer/Director/Trustee Three

DAWN MARZO
DIRECTOR
24 RIDGEFIELD CIR
BOYLSTON MA 01505-1552

Officer/Director/Trustee Four

DANA MCCUE
DIRECTOR
150 CHURCH ST
NORTHBOROUGH MA 01532-1343

Officer/Director/Trustee Five

DEB SAN CLEMENTE
DIRECTOR
17 SETTLERS RD
SHREWSBURY MA 01545-7720

Organization’s website
Organization’s email SBSFAMILYFUND@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 9/16/2015
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code B11 - Single Organization Support
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
Signature Title
Signature Date

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