FORM 1023-EZ for ANDREWS LOCKER FOUNDATION INC

Field Data
EIN 84-4529536
Case Number EO-2020041-000602
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name ANDREWS LOCKER FOUNDATION INC
Organization’s Mailing Address 17 ROCKY RIDGE ROAD
City WEST HARRISON
State NY
ZIP 10604-2010
Accounting period End 12
Primary contact name PERRY GROSSER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

PERRY GROSSER
PRESIDENT
17 ROCKY RIDGE ROAD
WEST HARRISON NY 10604-2010

Officer/Director/Trustee Two

DOROTHY GROSSER
DIRECTOR
17 ROCKY RIDGE ROAD
WEST HARRISON NY 10604-2010

Officer/Director/Trustee Three

NICOLE GROSSER
DIRECTOR
17 ROCKY RIDGE ROAD
WEST HARRISON NY 10604-2010

Officer/Director/Trustee Four

GREG ROSMAN
DIRECTOR
1007 WILLOW AVENUE APT 6
HOBOKEN NJ 07030-3198

Officer/Director/Trustee Five

TODD ROSMAN
DIRECTOR
2971 BAINBRIDGE AVENUE APT 1A
BRONX NY 10458-2143

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/29/2020
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code N60 - Amateur Sports Clubs, Leagues, 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 PERRY GROSSER
Signature Title PRESIDENT
Signature Date 2/7/2020

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