FORM 1023-EZ for COMMUNITY VACATION CAMP INC

Field Data
EIN 82-2653067
Case Number EO-2017258-000050
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name COMMUNITY VACATION CAMP INC
Organization’s Mailing Address 212 GARDEN STREET
City WESTBURY
State NY
ZIP 11590
Accounting period End 12
Primary contact name MONIQUE HARVEY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

BISHOP LIONEL HARVEY
BOARD MEMBER
35 CANTIAGUE LANE
WESTBURY NY 11590

Officer/Director/Trustee Two

ROSETTA CAINES
OFFICER
619 ROMAN AVE
WESTBURY NY 11590

Officer/Director/Trustee Three

LILLIAN SHELTON
BOARD MEMBER
812 SOUTH DRIVE
BALDWIN NY 11510

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/2/2017
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N20 - Recreational and Sporting Camps
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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