FORM 1023-EZ for A FRESH LIFE START INC

Field Data
EIN 82-4982250
Case Number EO-2018107-000835
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name A FRESH LIFE START INC
Organization’s Mailing Address PO BOX 1110
City RONKONKOMA
State NY
ZIP 11779-890
Accounting period End 12
Primary contact name LEONARD FRITZSON
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

MARCOBERY GOMEZ
PRESIDENT
807 VISTA VIEW DRIVE
FARMINGVILLE NY 11738-3010

Officer/Director/Trustee Two

DANIA ESCOBAR
VICE PRESIDENT
807 VISTA VIEW DRIVE
FARMINGVILLE NY 11738-3010

Officer/Director/Trustee Three

BERNARD FIGLER
SECRETARY
43 ROCKY POINT ROAD
MIDDLE ISLAND NY 11953-1218

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 3/19/18
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code L41 - Homeless, Temporary Shelter For
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 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 MARCOBERY GOMEZ
Signature Title PRESIDENT
Signature Date 3/29/18

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