FORM 1023-EZ for BOSTON PSYCHEDELIC RESEARCH GROUP INC

Field Data
EIN 84-4240195
Case Number EO-2020149-000238
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name BOSTON PSYCHEDELIC RESEARCH GROUP INC
Organization’s Mailing Address 174 LAKEVIEW AVENUE
City CAMBRIDGE
State MA
ZIP 02138-2132
Accounting period End 12
Primary contact name SHIPPEN L PAGE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANNE ST GOAR
PRESIDENT AND DIRECTOR
174 LAKEVIEW AVENUE
CAMBRIDGE MA 02138-2132

Officer/Director/Trustee Two

RICHARD SIMON
CLERK AND DIRECTOR
25 CRESCENT STREET
WALTHAM MA 02453-1234

Officer/Director/Trustee Three

RONALD MIS
TREASURER AND DIRECTOR
20 BULLARD ROAD
WESTON MA 02493-2231

Officer/Director/Trustee Four

SHIPPEN PAGE
DIRECTOR
174 LAKEVIEW AVENUE
CAMBRIDGE MA 02138-2132

Officer/Director/Trustee Five

GIORGIANNA ELLIS
DIRECTOR
20 BULLARD ROAD
WESTON MA 02493-2231

Organization’s website
Organization’s email SHIPPEN@SHIPPENPAGE.COM
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/10/2020
Organization Incorporation State MA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W99 - Public, Society Benefit - Multipurpose and Other N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
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 SHIPPEN PAGE
Signature Title DIRECTOR
Signature Date 5/26/2020

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