FORM 1023-EZ for ROAD SAFETY USA INC

Field Data
EIN 84-3211286
Case Number EO-2019289-000128
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ROAD SAFETY USA INC
Organization’s Mailing Address 2111 STATE ROUTE 203
City CHATHAM
State NY
ZIP 12037
Accounting period End 12
Primary contact name SUSAN WREN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SUSAN WREN
PRESIDENT
2111 STATE ROUTE 203
CHATHAM NY 12037

Officer/Director/Trustee Two

EDWIN WREN
EXECUTIVE DIRECTOR
2111 STATE ROUTE 203
CHATHAM NY 12037

Officer/Director/Trustee Three

SAMANTHA CANTON
SECRETARY
8 MELROSE RD UPPER
AMHERST NY 14221

Officer/Director/Trustee Four

JOHN BEECROFT
VICE PRESIDENT
641 CALLE DEL NORTE
CAMARILLO CA 93010

Officer/Director/Trustee Five

ROBIN MAYER
DIRECTOR
53 CHURCH ST
DAMARISCOTTA ME 4543

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 8/13/19
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code M42 - Automotive Safety
Organization’s purpose Charitable: Yes
Religious: No
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 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 SUSAN WREN
Signature Title PRESIDENT
Signature Date 10/10/19

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