FORM 1023-EZ for POPCORN ROULETTE

Field Data
EIN 84-2118878
Case Number EO-2019240-000088
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name POPCORN ROULETTE
Organization’s Mailing Address 8 MYRON ROAD
City HAVERHILL
State MA
ZIP 1830
Accounting period End 12
Primary contact name JOHN-MICHAEL GARIEPY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JOHN-MICHAEL GARIEPY
DIRECTOR
8 MYRON ROAD
HAVERHILL MA 1830

Officer/Director/Trustee Two

JEANNE GARIEPY
DIRECTOR
8 MYRON ROAD
HAVERHILL MA 1830

Officer/Director/Trustee Three

WENDI COMEAU
DIRECTOR
1 GRANT ST
HAVERHILL MA 1830

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/16/19
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A20 - Arts, Cultural Organizations - Multipurpose
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
Scientific: No
Literary: Yes
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 No
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name JOHN-MICHAEL GARIEPY
Signature Title DIRECTOR
Signature Date 8/26/19

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