FORM 1023-EZ for INTERNATIONAL BREAST CANCER SURGICAL MISSION

Field Data
EIN 86-2303052
Case Number EO-2021204-000196
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name INTERNATIONAL BREAST CANCER SURGICAL MISSION
Organization’s Mailing Address 240 MEETING HOUSE LN
City SOUTHAMPTON
State NY
ZIP 11968
Accounting period End 12
Primary contact name EDNA KAPENHAS
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

EDNA KAPENHAS
DIRECTOR
10 JAGGER COURT
MELVILLE NY 11747

Officer/Director/Trustee Two

VINAY TAK
DIRECTOR
10 JAGGER COURT
MELVILLE NY 11747

Officer/Director/Trustee Three

GLORIA LOFSTAD
DIRECTOR
177 SPRINGVILLE RD
HAMPTON BAYS NY 11946

Organization’s website IBCSMUS.COM
Organization’s email INFO@IBCSMUS.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 12/4/2020
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code G30 - Cancer
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 Yes
Financial transactions with officers Yes
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 EDNA KAPENHAS
Signature Title DIRECTOR
Signature Date 7/21/2021

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