FORM 1023-EZ for SAM RISSO FOUNDATION INC

Field Data
EIN 86-3839835
Case Number EO-2021160-000355
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SAM RISSO FOUNDATION INC
Organization’s Mailing Address 441 SANTA ANNA DR
City PALM SPRINGS
State FL
ZIP 33461
Accounting period End 12
Primary contact name ELIZABETH CHELAK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ELIZABETH CHELAK
PRESIDENT
441 SANTA ANNA DR
PALM SPRINGS FL 33461

Officer/Director/Trustee Two

ANNA SCHWAB
TREASURER
5028 ASHLEY LAKE DR APT 336
BOYNTON BEACH FL 33437

Officer/Director/Trustee Three

GARY EVANS
SECRETARY
3015 FLORIDA BLVD
DELRAY BEACH FL 33483

Organization’s website SAMRISSOFOUNDATION.ORG
Organization’s email HELLO@LIZCHELAK.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/11/2021
Organization Incorporation State FL
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 Yes
Donation of funds Yes
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 ELIZABETH CHELAK
Signature Title PRESIDENT
Signature Date 6/7/2021

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