FORM 1023-EZ for PHILIPSTOWN AGING AT HOME INC

Field Data
EIN 83-2826282
Case Number EO-2019028-000299
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name PHILIPSTOWN AGING AT HOME INC
Organization’s Mailing Address PO BOX 74
City COLD SPRING
State NY
ZIP 10516
Accounting period End 6
Primary contact name ELIZABETH BRADFORD
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SHEILA RAUCH
BOARD CHAIR, DIRECTOR
PO BOX 74
COLD SPRING NY 10516

Officer/Director/Trustee Two

ELLEN RAPHAEL COLLINS
TREASURER, DIRECTOR
PO BOX 74
COLD SPRING NY 10516

Officer/Director/Trustee Three

ELLYN VARELA-BURSTEIN
SECRETARY, DIRECTOR
PO BOX 74
COLD SPRING NY 10516

Officer/Director/Trustee Four

ANNE IMPELLIZERI
DIRECTOR
PO BOX 74
COLD SPRING NY 10516

Officer/Director/Trustee Five

CAROL NEWMAN
DIRECTOR
PO BOX 74
COLD SPRING NY 10516

Organization’s website
Organization’s email PAAH@OPTONLINE.NET
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/13/18
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P80 - Services to Promote the Independence of Specific Populations
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 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 ELLEN RAPHAEL COLLINS
Signature Title TREASURER, DIRECTOR
Signature Date 12/14/18

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