FORM 1023-EZ for BALLROOM ACCESSIBLE INC

Field Data
EIN 81-1589884
Case Number EO-2017219-000519
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name BALLROOM ACCESSIBLE INC
Organization’s Mailing Address 1350 UNIVERSITY AVENUE
City ROCHESTER
State NY
ZIP 14607
Accounting period End 12
Primary contact name ROBERT KAUFFMAN
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ROBERT KAUFFMAN
PRESIDENT
267 OXFORD ST APT 707
ROCHESTER NY 14607

Officer/Director/Trustee Two

MARINA LISSER
TREASURER
23 EMERALD HILL CIRCLE
FAIRPORT NY 14450

Officer/Director/Trustee Three

JUBIN MATLOUBIEH
SECRETARY
2 WHITE BRIAR
PITTSFORD NY 14534

Organization’s website
Organization’s email BALLROOMACCESSIBLE@GMAIL.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 2/24/2016
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code A62 - Dance
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 Yes
Donation of funds Yes
Conducting Activities Outside of United States No
Financial transactions with officers Yes
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
Signature Title
Signature Date

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