FORM 1023-EZ for FRAGILE X FAMILY ALLIANCE

Field Data
EIN 81-2231587
Case Number EO-2016308-000235
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name FRAGILE X FAMILY ALLIANCE
Organization’s Mailing Address 30 GARFIELD PLACE SUITE 920
City CINCINNATI
State OH
ZIP 45202
Accounting period End 12
Primary contact name J TIMOTHY RIKER ESQ
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PAUL HEISEL
PRESIDENT
5592 FOLEY ROAD
CINCINNATI OH 45238

Officer/Director/Trustee Two

JOE CAROLIN
TREASURER
966 HICKORY VIEW DRIVE
CINCINNATI OH 45233

Officer/Director/Trustee Three

DR AMY HEISEL
VICE PRESIDENT
966 HICKORY VIEW DRIVE
CINCINNATI OH 45233

Officer/Director/Trustee Four

LAURIE LUPINETTI
SECRETARY
3415 BROKEN RIDGE DRIVE
MASON OH 45040

Officer/Director/Trustee Five

REBECCA KELLY
VOTING MEMBER
1500 EBENEEZER
CINCINNATI OH 45233

Organization’s website NONE
Organization’s email FRAGILEXFAMILYALLIANCE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/13/2015
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G20 - Birth Defects and Genetic Diseases
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
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
Signature Title
Signature Date

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