FORM 1023-EZ for THE ROLE INITIATIVE

Field Data
EIN 82-1946994
Case Number EO-2019038-000893
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name THE ROLE INITIATIVE
Organization’s Mailing Address 17 UNION RD
City STRATHAM
State NH
ZIP 3885
Accounting period End 5
Primary contact name MARK MERIDA
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ERIC BOAEN
DIRECTOR
931 METHUEN ST UNIT 8
DRACUT MA 1826-5310

Officer/Director/Trustee Two

MARK MERIDA
DIRECTOR AND OWNER
17 UNION RD
STRATHAM NH 3885-2423

Officer/Director/Trustee Three

DAVID JEDLINSKY
DIRECTOR
120 WHEELER RD
HOLLIS NH 3049

Officer/Director/Trustee Four

ADAM SCARAMELLA
DIRECTOR
300 CONCORD ST
HOLLISTON MA 1746

Officer/Director/Trustee Five

DEBORAH BERLIN
DIRECTOR
81 SUMMER ST APARTMENT 2
WATERTOWN MA 2472

Organization’s website THEROLEINITIATIVE.ORG
Organization’s email MARK.MERIDA@THEROLEINITIATIVE.ORG
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/5/16
Organization Incorporation State NH
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: 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MARK MERIDA
Signature Title DIRECTOR AND OWNER
Signature Date 1/25/19

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