FORM 1023-EZ for KOSIELIAS FOUNDATION INC

Field Data
EIN 82-3361679
Case Number EO-2018089-000313
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name KOSIELIAS FOUNDATION INC
Organization’s Mailing Address 416 HIBBARD ROAD
City HORSEHEADS
State NY
ZIP 14845
Accounting period End 12
Primary contact name TRACEY BOLOTNICK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

ANGELA NWANERI
PRESIDENT DIRECTOR
303 LYON CIRCLE
DOYLESTOWN PA 18902

Officer/Director/Trustee Two

AKUA ASIEDU
TREASURER AND DIRECTOR
10158 GOODIN CIRCLE
COLUMBIA MD 21046

Officer/Director/Trustee Three

HENRY YEBOAH AKRONG
SECRETARY AND DIRECTOR
1150 WALNUT STREET
NEWTON MA 2461

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/9/17
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code E99 - Health - General and Rehabilitative N.E.C.
Organization’s purpose Charitable: Yes
Religious: No
Educational: Yes
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 Yes
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 ANGELA NWANERI
Signature Title PRESIDENT DIRECTOR
Signature Date 3/28/18

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