FORM 1023-EZ for JUNE BRAY MEMORIAL PLAYGROUND INC

Field Data
EIN 22-2310610
Case Number EO-2017109-000102
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name JUNE BRAY MEMORIAL PLAYGROUND INC
Organization’s Mailing Address PO BOX 425
City CAMDEN
State NY
ZIP 13316
Accounting period End 12
Primary contact name JENNY GRASS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JENNY GRASS
PRESIDENT
10817 ROWELL RD
CAMDEN NY 13316

Officer/Director/Trustee Two

ROBERT HARTER
VICE PRESIDENT
PO BOX 74
WESTDALE NY 13483

Officer/Director/Trustee Three

MARK GRASS
TREASURER
11065 CEMETARY RD
WESTDALE NY 13483

Officer/Director/Trustee Four

SANDRA SWETT
SECRETARY
11612 STATE ROUTE 13
WESTDALE NY 13483

Officer/Director/Trustee Five

RAY HOLLIBAUGH
TRUSTEE
11176 STATE ROUTE 13
WESTDALE NY 13483

Organization’s website
Organization’s email JUNEBRAYPLAYGROUND@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/26/1972
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N32 - Parks and Playgrounds
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 Yes
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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