FORM 1023-EZ for CHILDRENS INTEGRATED CENTER FOR SUCCESS FOUNDATION

Field Data
EIN 84-1908385
Case Number EO-2019151-000235
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name CHILDRENS INTEGRATED CENTER FOR SUCCESS FOUNDATION
Organization’s Mailing Address 1247 S CEDAR CREST BLVD STE 100
City ALLENTOWN
State PA
ZIP 18103
Accounting period End 12
Primary contact name JULIE M MACOMB ESQUIRE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

AMY EDGAR
PRESIDENT AND DIRECTOR
2057 TUMBLEBROOK ROAD
COOPERSBURG PA 18036

Officer/Director/Trustee Two

GAIL EVANS
VICE PRESIDENT AND DIRECTOR
4539 FREEDOM WAY
CENTER VALLEY PA 18034

Officer/Director/Trustee Three

CINDY FISHER
TREASURER AND DIRECTOR
2833 MEADOWBROOK SOUTH
ALLENTOWN PA 18103

Officer/Director/Trustee Four

WILLIAM FISHER
SECRETARY AND DIRECTOR
2833 MEADOWBROOK CIRCLE SOUTH
ALLENTOWN PA 18103

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/29/19
Organization Incorporation State PA
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 Yes
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 No
One Third Support Gifts Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name AMY EDGAR
Signature Title PRESIDENT AND DIRECTOR
Signature Date 5/29/19

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