FORM 1023-EZ for SUBURBAN LASERTOMA INCORPORATED

Field Data
EIN 83-2322389
Case Number EO-2018319-000305
Form 1023-EZ version 12018
Eligibility Worksheet 1
Organization Name SUBURBAN LASERTOMA INCORPORATED
Organization’s Mailing Address 3989 ANDREW LAKE PLACE
City POWELL
State OH
ZIP 43065-7339
Accounting period End 7
Primary contact name JAMES W WANDRYCH
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

SANDRA WANDRYCH
PRESIDENT
3989 ANDREW LAKE PL
POWELL OH 43065-7339

Officer/Director/Trustee Two

LYNN SHOMAKER
SECRETARY
6545 STEITZ RD
POWELL OH 43065-7934

Officer/Director/Trustee Three

PAULA ROLLER
TREASURER
366 FORESTWOOD DR
COLUMBUS OH 43230-2082

Officer/Director/Trustee Four

MARY GREBE
VICE PRESIDENT
615 RETREAT LANE N
POWELL OH 43065-7610

Officer/Director/Trustee Five

CYNTHIA HEINRICHS
CHAIRWOMEN
1620 E BROAD ST NO 607
COLUMBUS OH 43203-2021

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 11/13/18
Organization Incorporation State OH
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code W12 - 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 Yes
Benefit of College No
Private Foundation 508(e) No
Seeking Retroactive Reinstatement No
Seeking Section 7 Reinstatement No
Correctness Declaration Yes
Signature Name SANDRA WANDRYCH
Signature Title PRESIDENT
Signature Date 11/13/18

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