FORM 1023-EZ for SUPPORTERS OF THE BLOOMFIELD ANIMALSHELTER A NJ NONPROFIT CORPORATION

Field Data
EIN 81-2821089
Case Number EO-2016187-000426
Form 1023-EZ version 62014
Eligibility Worksheet 1
Organization Name SUPPORTERS OF THE BLOOMFIELD ANIMALSHELTER A NJ NONPROFIT CORPORATION
Organization’s Mailing Address 180 FRANKLIN STREET APT 20
City BLOOMFIELD
State NJ
ZIP 07003-4828
Accounting period End 12
Primary contact name MIRIAM MICHALSKI
Primary contact phone [Hidden]
Primary contact phone extension [Hidden]
Primary contact fax [Hidden]
User fee submitted $275.00
Officer/Director/Trustee One

JACLYN MENDYK
PRESIDENT
180 FRANKLIN STREET APT 20
BLOOMFIELD NJ 07003-4828

Officer/Director/Trustee Two

MARLENE LATORRE
TREASURER
180 FRANKLIN STREET APT 20
BLOOMFIELD NJ 07003-4828

Officer/Director/Trustee Three

PAIGE SATO
VICE PRESIDENT
180 FRANKLIN STREET APT 20
BLOOMFIELD NJ 07003-4828

Officer/Director/Trustee Four

DIANE MYER
SECRETARY
180 FRANKLIN STREET APT 20
BLOOMFIELD NJ 07003-4828

Officer/Director/Trustee Five

MIRIAM MICHALSKI
INCORPORATOR/TRUSTEE
180 FRANKLIN STREET APT 20
BLOOMFIELD NJ 07003-4828

Organization’s website
Organization’s email
Organization Incorporated Yes
Organization trust No
Necessary Organizing Documents Yes
Organization Incorporation Date 5/25/2016
Organization Incorporation State NJ
Contains Limitation Yes
Does not expressly empower Yes
Contains dissolution Yes
National Taxonomy of Exempt Entities (NTEE) code D11 - Single Organization Support
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 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 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
Signature Title
Signature Date

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