FORM 1023-EZ for STATE STREET HEROES FUND

Field Data
EIN 11-3639997
Case Number EO-2019238-000645
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name STATE STREET HEROES FUND
Organization’s Mailing Address 32 BALSAM DRIVE
City DIX HILLS
State NY
ZIP 11746
Accounting period End 10
Primary contact name MATTHEW JACOBY
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MATTHEW JACOBY
PRESIDENT
32 BALSAM DRIVE
DIX HILLS NY

Officer/Director/Trustee Two

PETER CHIODO
TREASURER
53 SLATER BLVD
STATEN ISLAND NY 10305

Officer/Director/Trustee Three

PETER CULKIN
SECRETARY
55 SEAFIELD LANE
BAYSHORE NY 11706

Officer/Director/Trustee Four

JACK HALABY
ASST. SECRETARY
23 WILSON STREET
STATEN ISLAND NY 10304

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/30/01
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Z99 - Unclassified
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 Yes
One Third Support Gifts No
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement Yes
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name MATTHEW JACOBY
Signature Title PRESIDENT
Signature Date 8/23/19

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