FORM 1023-EZ for TEAM LACIE JAE INC

Field Data
EIN 85-3844525
Case Number EO-2021097-001525
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name TEAM LACIE JAE INC
Organization’s Mailing Address 11 CIRCLE DRIVE
City HYDE PARK
State NY
ZIP 12538
Accounting period End 12
Primary contact name DORA L VISBECK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

DORA VISBECK
PRESIDENT
11 CIRCLE DRIVE
HYDE PARK NY 12538

Officer/Director/Trustee Two

NADINE SNIPE
VICE PRESIDENT
117 ROOSEVELT ROAD
HYDE PARK NY 12538

Officer/Director/Trustee Three

SIOBHAN BUBEL
SECRETARY
24 HUDSON DRIVE
HYDE PARK NY 12538

Officer/Director/Trustee Four

GAYLE SHEEDY
TREASURER
3 IDLEWILD DRIVE
POUGHKEEPSIE NY 12601

Organization’s website
Organization’s email TEAMLACIEJAE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/4/2021
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E99 - Health - General and Rehabilitative 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 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 DORA VISBECK
Signature Title PRESIDENT
Signature Date 3/16/2021

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