FORM 1023-EZ for HELP SAMI KICK CANCER FOUNDATION INC

Field Data
EIN 83-2253365
Case Number EO-2019028-000074
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name HELP SAMI KICK CANCER FOUNDATION INC
Organization’s Mailing Address 5905 COUNTRY ROUTE 27
City CANTON
State NY
ZIP 13617
Accounting period End 12
Primary contact name KATHLEEN MULKIN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ELLIS J CURTIS JR
PRESIDENT
335 BREWER ROAD
CANTON NY 13617

Officer/Director/Trustee Two

KAREN CURTIS
VICE PRESIDENT
335 BREWER ROAD
CANTON NY 13617

Officer/Director/Trustee Three

KATHLEEN MULKIN
SECRETARY TREASURER
5905 COUNTRY ROUTE 27
CANTON NY 13617

Officer/Director/Trustee Four

ALAN MULKIN
DIRECTOR
5905 COUNTRY ROUTE 27
CANTON NY 13617

Officer/Director/Trustee Five

MARK BRACKETT
DIRECTOR
651 STATE HIGHWAY 310
CANTON NY 13617

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/15/18
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - Fund Raising and/or Fund Distribution
Organization’s purpose Charitable: Yes
Religious: Yes
Educational: Yes
Scientific: Yes
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 KATHLEEN MULKIN
Signature Title SECRETARY TREASURER
Signature Date 12/13/18

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