FORM 1023-EZ for THE PAIGE ELIZABETH KEELY FOUNDATION

Field Data
EIN 84-5024812
Case Number EO-2020069-000678
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE PAIGE ELIZABETH KEELY FOUNDATION
Organization’s Mailing Address 11 NORTHFILED LANE
City NISSEQUOGUE
State NY
ZIP 11780
Accounting period End 2
Primary contact name GINA KEELY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

GINA KEELY
FOUNDER - PRESIDENT
11 NORTHFILED LANE
NISSEQUOGUE NY 11780

Officer/Director/Trustee Two

RACHEL HUJBER
VICE PRESIDENT
34 HAMPTON DR
CENTER MORICHES NY 11934

Officer/Director/Trustee Three

KATHLEEN DUNPHY
MARKETING DIRECTOR
1249 HOLLY ROAD
WANTAGH NY 11793

Officer/Director/Trustee Four

JOAN KEELY
LEGAL DIRECTOR
255 GREAT NECK ROAD APT306
GREAT NECK NY 11021

Officer/Director/Trustee Five

KATHLEEN LAROSA
DIRECTOR OF RESEARCH AND DEVELOPMEN
8533 ALOPHIA DR
AUSTIN TX 78739

Organization’s website
Organization’s email GINAJEZZ@OPTONLINE.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/26/2020
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E12 - Fund Raising and/or Fund Distribution
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 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 GINA KEELY
Signature Title FOUNDER - PRESIDENT
Signature Date 3/7/2020

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