FORM 1023-EZ for MARY DI ROSA ACADEMY

Field Data
EIN 47-5372164
Case Number EO-2015331-000236
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name MARY DI ROSA ACADEMY
Organization’s Mailing Address 116 YORK GATE DR
City PATASKALA
State OH
ZIP 43062
Accounting period End 6
Primary contact name ALLISON R SHARDELL
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

ALLISON SHARDELL
EXECUTIVE DIRECTOR
116 YORK GATE DR
PATASKALA OH 43062

Officer/Director/Trustee Two

AMY CARUSO
BOARD MEMBER
116 YORK GATE DR
PATASKALA OH 43062

Officer/Director/Trustee Three

ELYN TIBBS
BOARD MEMBER
116 YORK GATE DR
PATASKALA OH 43062

Officer/Director/Trustee Four

STEPHANIE WISSMAN
BOARD MEMBER
116 YORK GATE DR
PATASKALA OH 43062

Organization’s website HTTP://WWW.MARYDIROSAACADEMY.COM
Organization’s email ADSHARDELL@YAHOO.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/24/2015
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P30 - Children's, Youth Services
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 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 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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