FORM 1023-EZ for UPLIFT HEALTH INC

Field Data
EIN 47-4716664
Case Number EO-2016165-000332
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name UPLIFT HEALTH INC
Organization’s Mailing Address 16 OCEAN PKWY E24
City BROOKLYN
State NY
ZIP 11218-1552
Accounting period End 6
Primary contact name MICHELLE SKAER
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

MICHELLE SKAER
OFFICER
118 E 102ND ST 3A
NEW YORK NY 10029-5765

Officer/Director/Trustee Two

JEAN-PHILIPPE THERRIEN
OFFICER
16 OCEAN PKWY APT E24
BROOKLYN NY 11218-1552

Officer/Director/Trustee Three

ELEANOR TIMRECK
OFFICER
360 W 20TH ST 4F
NEW YORK NY 10011-3389

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 7/29/2015
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code Q30 - International Development, Relief Services
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 Yes
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 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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