FORM 1023-EZ for KEMP MILL VILLAGE INC

Field Data
EIN 83-0946587
Case Number EO-2018176-000270
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KEMP MILL VILLAGE INC
Organization’s Mailing Address 1121 UNIVERSITY BLVD W APT 703
City SILVER SPRING
State MD
ZIP 20902-3319
Accounting period End 12
Primary contact name ALAN L BREITLER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ALAN BREITLER
PRESIDENT
1121 UNIVERSITY BLVD W APT 703
SILVER SPRING MD 20902-3319

Officer/Director/Trustee Two

BARBARA MARCUS
BOARD MEMBER
503 SISSON ST
SILVER SPRING MD 20902-3152

Officer/Director/Trustee Three

STUART ROSENTHAL
BOARD MEMBER
1220 ARCOLA AVE
SILVER SPRING MD 20902-3408

Officer/Director/Trustee Four

IRA UNGAR
BOARD MEMBER
613 WINONA CT
SILVER SPRING MD 20902-3265

Officer/Director/Trustee Five

MELANIE KMETZ
BOARD MEMBER
1010 N BELGRADE
SILVER SPRING MD 20902-3260

Organization’s website
Organization’s email alanb336@hotmail.com
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 6/13/18
Organization Incorporation State MD
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P99 - Human Services - Multipurpose and Other N.E.C.
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 ALAN BREITLER
Signature Title PRESIDENT
Signature Date 6/21/18

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