FORM 1023-EZ for LONG ISLAND AUTISM COMMUNITIES IN

Field Data
EIN 47-3627259
Case Number EO-2015110-000252
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name LONG ISLAND AUTISM COMMUNITIES IN
Organization’s Mailing Address 724 LONG ISLAND AVENUE
City DEER PARK
State NY
ZIP 11729
Accounting period End 12
Primary contact name CHARLES MASSIMO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

CHARLES MASSIMO
PRESIDENT
724 LONG ISLAND AVE
DEER PARK NY 11729

Officer/Director/Trustee Two

PAUL CRACO
SECRETARY
7 HIGH STREET STE 2000
HUNTINGTON NY 11743

Officer/Director/Trustee Three

RICK WEIDERSUM
TREARURER
140 ADAMS AVE STE B-14
HAYPPAUGE NY 11788

Officer/Director/Trustee Four

PETER SMERGUT
BOARD MEMBER
201 E 17TH ST APT 22B
NEW YORK NY 10003

Officer/Director/Trustee Five

GORDON SIESS
BOARD MEMBER
125 BAYLIS RD
MELVILLE NY 11747

Organization’s website WWW.COMMUNITIESFORAUTISM.ORG
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 4/1/2015
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G84 - Autism
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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