FORM 1023-EZ for NKMC OLD DOMINION CHAPTER INC

Field Data
EIN 47-3066188
Case Number EO-2015057-000088
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name NKMC OLD DOMINION CHAPTER INC
Organization’s Mailing Address 13723 AIR AND SPACE MUSEUM PARKWAY
City HERNDON
State VA
ZIP 20171
Accounting period End 12
Primary contact name MICHAEL QUICK
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

LOU TOMASSO
DIRECTOR/PRESIDENT
13723 AIR AND SPACE MUSEUM PARKWAY
HERNDON VA 20171

Officer/Director/Trustee Two

MICHAEL QUICK
DIRECTOR/TREASURER
320 N CONSTITUTION WAY
PURCELLVILLE VA 20132

Officer/Director/Trustee Three

BOBBY SANSALE
DIRECTOR/CHAIRPERSON
3117 FENNEGAN COURT
WOODBRIDGE VA 22192

Officer/Director/Trustee Four

CARLOS RIVERA-SILVA
DIRECTOR/VICE PRESIDENT
13346 FERRY LANDING LANE
WOODBRIDGE VA 22191

Officer/Director/Trustee Five

GARY LOWMAN
DIRECTOR/SECRETARY
4507 HAMILTON DRIVE
WOODBRIDGE VA 22193

Organization’s website NA
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/29/2015
Organization Incorporation State VA
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code P12 - Fund Raising and/or Fund Distribution
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 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 No
Benefit of College No
Private Foundation 508(e) Yes
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name
Signature Title
Signature Date

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