FORM 1023-EZ for MY XXY
| Field | Data |
|---|---|
| EIN | 85-1050645 |
| Case Number | EO-2021084-001214 |
| Form 1023-EZ version | 12018 |
| Eligibility Worksheet | 1 |
| Organization Name | MY XXY |
| Organization’s Mailing Address | 2307 S RURAL ROAD |
| City | TEMPE |
| State | AZ |
| ZIP | 85282 |
| Accounting period End | 12 |
| Primary contact name | ELLIS M CARTER ESQ |
| Primary contact phone | [Hidden] |
| Primary contact phone extension | [Hidden] |
| Primary contact fax | [Hidden] |
| User fee submitted | $275.00 |
Officer/Director/Trustee One
ELLIOT POLAK
CEO AND DIRECTOR
2307 S RURAL ROAD
TEMPE AZ 85282
Officer/Director/Trustee Two
RHODORA CRESCENCIA
SECRETARY
2307 S RURAL ROAD
TEMPE AZ 85282
Officer/Director/Trustee Three
EDMAR TAN
TREASURER
2307 S RURAL ROAD
TEMPE AZ 85282
Officer/Director/Trustee Four
CLOTILDE IAIA
DIRECTOR
2307 S RURAL ROAD
TEMPE AZ 85282
Officer/Director/Trustee Five
ULYSSE POLAK
DIRECTOR
2307 S RURAL ROAD
TEMPE AZ 85282
| Organization’s website | |
|---|---|
| Organization’s email | |
| Organization Incorporated | Yes |
| Organization trust | No |
| Necessary Organizing Documents | Yes |
| Organization Incorporation Date | 5/1/2020 |
| Organization Incorporation State | AZ |
| Contains Limitation | Yes |
| Does not expressly empower | Yes |
| Contains dissolution | Yes |
| National Taxonomy of Exempt Entities (NTEE) code | G20 - Birth Defects and Genetic Diseases |
| Organization’s purpose | Charitable: Yes Religious: No Educational: No Scientific: Yes 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 | ELLIOT POLAK |
| Signature Title | CEO AND DIRECTOR |
| Signature Date | 2/4/2021 |
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