FORM 1023-EZ for CAPITAL REGION COMMUNITY CAN INCORPORATED

Field Data
EIN 47-3001757
Case Number EO-2015037-000077
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name CAPITAL REGION COMMUNITY CAN INCORPORATED
Organization’s Mailing Address 418 N GREENBUSH ROAD
City RENSSELAER
State NY
ZIP 12144
Accounting period End 12
Primary contact name JUSTIN BELLEVILLE
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $400.00
Officer/Director/Trustee One

JUSTIN BELLEVILLE
DIRECTOR
418 N Greenbush Rd
Rensselaer NY 12144

Officer/Director/Trustee Two

MELVIN RIVERS
DIRECTOR
43 MCCLLOUGH AVE
RAVENA NY 12143

Officer/Director/Trustee Three

TREVOR CLARKE
DIRECTOR
1019 BALLTOWN ROAD
NISKAYUNA NY 12309

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 1/28/2015
Organization Incorporation State NY
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code T12 - 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 Yes
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 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
Signature Title
Signature Date

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