FORM 1023-EZ for POLISH KNIGHTS OF MALTA INC

Field Data
EIN 13-3784872
Case Number EO-2018051-000254
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name POLISH KNIGHTS OF MALTA INC
Organization’s Mailing Address 110 CHESTNUT RIDGE ROAD 177
City MONTVALE
State NJ
ZIP 7645
Accounting period End 12
Primary contact name ROBERT NIZIOL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBERT NIZIOL
DIRECTOR/PRESIDENT
110 CHESTNUT RIDGE ROAD 177
MONTVALE NJ 7645

Officer/Director/Trustee Two

TADEUSZ MIRECKI
DIRECTOR
900 N TAYLOR STREET 617
ARLINGTON VA 22203

Officer/Director/Trustee Three

TERESA SULIMIRSKI
DIRECTOR
3 STONELEIGH APT 4E
BRONXVILLE NY 10708-2608

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/21/86
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P20 - Human Service Organizations - Multipurpose
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 No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name ROBERT NIZIOL
Signature Title DIRECTOR/PRESIDENT
Signature Date 2/16/18

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