FORM 1023-EZ for DOVER SHOCKWAVE ROBOTICS CORPORATION

Field Data
EIN 47-1389117
Case Number EO-2015161-000574
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name DOVER SHOCKWAVE ROBOTICS CORPORATION
Organization’s Mailing Address 581 TOLEND ROAD
City DOVER
State NH
ZIP 03820
Accounting period End 8
Primary contact name JOSEPH PISCIELLO
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JAMES COLE
DIRECTOR
6 CRANBROOK LANE
DOVER NH 03820

Officer/Director/Trustee Two

MERVIN FAULKNER
DIRECTOR
125 MAIN ST
NEWMARKET NH 03857

Officer/Director/Trustee Three

JOSEPH PISCITELLO
DIRECTOR
581 TOLEND ROAD
DOVER NH 03820

Officer/Director/Trustee Four

LISA MUNOZ
DIRECTOR
33 BASILS PLACE
DOVER NH 03820

Officer/Director/Trustee Five

ROBERT MEYER
DIRECTOR
36 WILDEWOOD LN
DOVER NH 03820

Organization’s website HTTP://DOVERSHOCKWAVE.WIX.COM/SHOCKWAVEROBOTICS
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 10/24/2014
Organization Incorporation State NH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code O50 - Youth Development Programs, Other
Organization’s purpose Charitable: No
Religious: No
Educational: Yes
Scientific: No
Literary: No
Public Safety: No
Amateur Sports: Yes
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 Yes
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
Signature Title
Signature Date

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