FORM 1023-EZ for CJS LIVING THE DREAM MEMORIAL FUND

Field Data
EIN 47-1595871
Case Number EO-2014239-000100
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CJS LIVING THE DREAM MEMORIAL FUND
Organization’s Mailing Address 6106 EASTON RD
City PIPERSVILLE
State PA
ZIP 18947
Accounting period End 12
Primary contact name TAMATHA POLICHETTI CPA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MELISSA DELLOREFICE
PRESIDENT
4418 LOWER MOUNTAIN RD
NEW HOPE PA 18938

Officer/Director/Trustee Two

TAMATHA POLICHETTI
TREASURER
829 KELLERS CHURCH RD
OTTSVILLE PA 18942

Officer/Director/Trustee Three

DENISE KEYS
VICE PRESIDENT
6063 ROOSEVELT BLVD APT 101
PHILADELPHIA PA 19149

Officer/Director/Trustee Four

SAMANTHA POLICHETTI
SECRETARY
829 KELLERS CHURCH RD
OTTSVILLE PA 18942

Organization’s website
Organization’s email
Organization Incorporated No
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/31/2014
Organization Incorporation State PA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O12 - 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 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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